系统治疗联合热消融与单纯系统治疗用于非小细胞肺癌寡转移肝的对比。
Systemic Therapy Plus Thermal Ablation Versus Systemic Therapy Alone for Oligometastatic Liver Metastases from Non-small Cell Lung Cancer.
机构信息
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Panjiayuan Nanli 17#, Chaoyang District, Beijing, 100021, China.
出版信息
Cardiovasc Intervent Radiol. 2020 Sep;43(9):1285-1293. doi: 10.1007/s00270-020-02456-y. Epub 2020 Mar 31.
PURPOSE
This study assessed and compared the efficacy and long-term outcomes of systemic therapy plus image-guided thermal ablation versus systemic therapy alone for oligometastatic liver metastases (LMs) from non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
This retrospective study was approved by the institutional review board. Written informed consent was waived due to the retrospective design. From November 2012 to December 2017, 61 patients (mean age 59.0 years; 35 males) with oligometastatic LMs from NSCLC (≤ 5 metastatic lesions) who received systemic therapy with (n = 21, group A) or without (n = 40, group B) thermal ablation were analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier curves.
RESULTS
The demographic and clinical characteristics were not significantly different between the groups (all P ≥ .05). In total, 28 LMs were entirely ablated, rendering a technical success rate of 100%, without major complications. The overall 6-month response rate was significantly higher in group A than in group B [57.1% (12/21) vs. 26.3% (10/38); P = .026]. The median PFS in group A was significantly longer than in group B [11.0 (95% CI 7.9-16.2) months vs. 5.2 (95% CI 3.7-7.9) months; P = .001]. However, the median OS was not significantly different [27.7 (95% CI 20.6-44.4) months vs. 17.7 (95% CI 14.5-27.5) months; P = .152].
CONCLUSION
Systemic therapy plus thermal ablation may prolong PFS but not OS in oligometastatic LMs from NSCLC.
目的
本研究评估并比较了全身治疗联合影像引导热消融与单纯全身治疗在治疗非小细胞肺癌（NSCLC）寡转移肝转移（LM）中的疗效和长期结果。
材料与方法
本回顾性研究获得了机构审查委员会的批准。由于研究设计为回顾性，故豁免了书面知情同意。2012 年 11 月至 2017 年 12 月，对 61 例 NSCLC 寡转移 LM（≤5 个转移灶）患者进行了全身治疗（n=21，A 组）或不联合（n=40，B 组）热消融的回顾性分析。采用 Kaplan-Meier 曲线估计无进展生存期（PFS）和总生存期（OS）。
结果
两组患者的人口统计学和临床特征无显著差异（均 P≥.05）。共有 28 个 LM 完全消融，技术成功率为 100%，无重大并发症。A 组的总 6 个月缓解率显著高于 B 组[57.1%（12/21）比 26.3%（10/38）；P=.026]。A 组的中位 PFS 明显长于 B 组[11.0（95%CI 7.9-16.2）个月比 5.2（95%CI 3.7-7.9）个月；P=.001]。然而，中位 OS 无显著差异[27.7（95%CI 20.6-44.4）个月比 17.7（95%CI 14.5-27.5）个月；P=.152]。
结论
全身治疗联合热消融可能延长 NSCLC 寡转移 LM 患者的 PFS，但不能延长 OS。
Zotero 插件