Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2018 Feb 21;52(3):281-288. doi: 10.2478/raon-2018-0009.
Background Standard treatment for patients with inoperable locally advanced non-small cell lung cancer (NSCLC) is concurrent chemoradiotherapy (CCRT). Five-year overall survival rates range between 15 and 25%, while long term survival data are rarely reported. Patients and methods A total of 102 patients with stage III NSCLC treated between September 2005 and November 2010 with induction chemotherapy and CCRT were included in this long term survival analysis. All patients were tested for PD-L1 status and expression of PD-L1 was correlated with overall survival (OS), progression free survival (PFS) and toxicities. Results The median OS of all patients was 24.8 months (95% CI 18.7 to 31.0) with 10 year-survival rate of 11.2%. The median OS of patients with PD-L1 expression was 12.1 months (95% CI 0.1 to 26.2), while in patients with negative or unknown PD-L1 status was significantly longer, 25.2 months (95% CI 18.9 to 31.6), p = 0.005. The median PFS of all patients was 16.4 months (95% CI 13.0 to 19.9). PFS of patients with PD-L1 expression was 10.1 months (95% CI 0.1 to 20.4) and in patients with negative or unknown PD-L1 status was 17.9 months (95% CI 14.2 to 21.7), p = 0.003. Conclusions 10-year overall survival of stage III NSCLC patients after CCRT is 11.2%. PFS and OS differ with regard to PD-L1 status and are significantly shorter for patients with PD-L1 expression. New treatment with check-point inhibitors combined with RT therefore seems reasonable strategy to improve these results.
无法手术的局部晚期非小细胞肺癌(NSCLC)患者的标准治疗方法是同期放化疗(CCRT)。5 年总生存率在 15%至 25%之间,而长期生存数据很少报道。
本长期生存分析共纳入 102 例 2005 年 9 月至 2010 年 11 月接受诱导化疗和 CCRT 治疗的 III 期 NSCLC 患者。所有患者均检测 PD-L1 状态,并将 PD-L1 表达与总生存期(OS)、无进展生存期(PFS)和毒性相关联。
所有患者的中位 OS 为 24.8 个月(95%CI 18.7 至 31.0),10 年生存率为 11.2%。PD-L1 表达患者的中位 OS 为 12.1 个月(95%CI 0.1 至 26.2),而 PD-L1 阴性或未知状态患者的中位 OS 明显更长,为 25.2 个月(95%CI 18.9 至 31.6),p = 0.005。所有患者的中位 PFS 为 16.4 个月(95%CI 13.0 至 19.9)。PD-L1 表达患者的 PFS 为 10.1 个月(95%CI 0.1 至 20.4),而 PD-L1 阴性或未知状态患者的 PFS 为 17.9 个月(95%CI 14.2 至 21.7),p = 0.003。
CCRT 后 III 期 NSCLC 患者的 10 年总生存率为 11.2%。PD-L1 状态与 PFS 和 OS 相关,PD-L1 表达患者的 PFS 和 OS 明显更短。因此,联合 RT 使用检查点抑制剂进行新的治疗似乎是改善这些结果的合理策略。