使用三联疗法评估非小细胞肺癌的失败模式
Evaluation of Failure Patterns Using Trimodality in Non-Small Cell Lung Cancer.
作者信息
Patel Shilpen, Pakish Janelle, Yen Philemon, Quang Tony, Carr Laurie, Wood Douglas, Eaton Keith, Mulligan Michael, Martins Renato
机构信息
Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA, USA.
Puget Sound Veterans Administration Seattle, WA, USA.
出版信息
World J Oncol. 2011 Apr;2(2):64-69. doi: 10.4021/wjon289w. Epub 2011 Apr 9.
BACKGROUND
The effectiveness of trimodality therapy in NSCLC has been controversial.
METHODS
Ninety-two patients with stage III NSCLC were analyzed retrospectively based on treatment given. Overall survival (OS) and patterns of failure were examined in patients treated with chemoradiation alone (Group 1) versus neoadjuvant chemoradiation followed by surgical resection (Group 2).
RESULTS
OS for 2, 3, and 5 years in Group 1 and 2 were 19.7%, 15.7%, and 4.5% versus 56.4%, 40.4%, and 32.3% (P = 0.003), respectively. Median survival for Group 1 and 2 was 11.0 and 34.0 months, respectively (P = 0.003). The recurrence rate in Group 1 was 61.8% (47 of 76) with distant non-brain involvement (48.9%). In Group 2 it was 50.0% (8 of 16) with brain (50%) involvement.
CONCLUSIONS
Patients with stage IIIA and, perhaps IIIB NSCLC with a high performance status should be considered for trimodality treatment.
背景
非小细胞肺癌（NSCLC）三联疗法的有效性一直存在争议。
方法
基于所接受的治疗方法，对92例III期NSCLC患者进行回顾性分析。比较单纯放化疗组（第1组）与新辅助放化疗后手术切除组（第2组）患者的总生存期（OS）及失败模式。
结果
第1组和第2组患者的2年、3年和5年总生存率分别为19.7%、15.7%和4.5%，以及56.4%、40.4%和32.3%（P = 0.003）。第1组和第2组的中位生存期分别为11.0个月和34.0个月（P = 0.003）。第1组的复发率为61.8%（76例中的47例），远处非脑转移占48.9%。第2组的复发率为50.0%（16例中的8例），脑转移占50%。
结论
对于体能状态良好的IIIA期及可能的IIIB期NSCLC患者，应考虑三联疗法。
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