Department of Radiation Oncology, Tianjin Medical University, Heping, Tianjin, 300070, China.
Shandong Adverse Drug Reaction Monitoring Center, Jinan, China.
J Cancer Res Clin Oncol. 2019 Oct;145(10):2605-2612. doi: 10.1007/s00432-019-03000-3. Epub 2019 Aug 13.
This study was designed to evaluate the role of thoracic radiotherapy (TRT) in a selected patient population with oligometastatic extensive stage small-cell lung cancer (ES-SCLC) without brain or liver involved. The underlying hypothesis was that TRT will improve outcomes in this favorable patient population.
305 patients were included in an institutional review board (IRB)-approved study, of which 105 received TRT after chemotherapy (ChT) and 200 received ChT alone. The survival outcomes were compared between ChT+TRT group and ChT-alone group in patients with oligometastasis without brain or liver involved and patients with brain/liver/multimetastasis, respectively.
The 1-year, 2-year and 5-year overall survival (OS) for all patients were 60.3%, 23.9% and 1.6%, respectively. The addition of TRT significantly improved PFS in total patients than ChT alone (14.5 months vs. 10.1 months, p = 0.006), but the OS benefit was not significant (17.8 months vs. 16.5 months, p = 0.061). For patients with oligometastasis (n = 118), TRT offered significant progression free survival (PFS) (16.5 months vs. 9.1 months, p = 0.005) and OS (19.2 months vs. 15.6 months, p = 0.039) benefits. However, for patients with brain/liver/multimetastasis, the PFS and OS were not improved with TRT (p = 0.49, p = 0.811).
TRT provided significant PFS and OS benefits in patients with oligometastatic ES-SCLC without brain or liver involved. The consolidative TRT is a reasonable treatment option for this favorable patient population.
本研究旨在评估胸部放疗（TRT）在无脑或肝转移的寡转移性广泛期小细胞肺癌（ES-SCLC）患者中的作用。研究的基本假设是，TRT 将改善这一有利患者群体的结局。
在机构审查委员会（IRB）批准的研究中，纳入了 305 名患者，其中 105 名患者在化疗（ChT）后接受了 TRT，200 名患者仅接受了 ChT。分别比较了无脑或肝转移的寡转移患者和脑/肝/多转移患者中，接受 ChT+TRT 组和 ChT 单一组的生存结局。
所有患者的 1 年、2 年和 5 年总生存率（OS）分别为 60.3%、23.9%和 1.6%。与 ChT 单一组相比，TRT 显著改善了总患者的 PFS（14.5 个月比 10.1 个月，p=0.006），但 OS 获益无统计学意义（17.8 个月比 16.5 个月，p=0.061）。对于寡转移患者（n=118），TRT 提供了显著的无进展生存（PFS）（16.5 个月比 9.1 个月，p=0.005）和 OS（19.2 个月比 15.6 个月，p=0.039）获益。然而，对于脑/肝/多转移患者，TRT 并未改善 PFS 和 OS（p=0.49，p=0.811）。
TRT 为无脑或肝转移的寡转移性 ES-SCLC 患者提供了显著的 PFS 和 OS 获益。巩固性 TRT 是这一有利患者群体的合理治疗选择。
