放疗对局限性原发性成人横纹肌肉瘤的生存获益

The survival benefit of radiotherapy in localized primary adult rhabdomyosarcoma.

作者信息

Zhao Ruping, Yu Xiaoli, Feng Yan, Wang Jian, Chen Yong, Mao Yanjiao, Yin Wei, Zhang Zhen, Guo Xiaomao, Ma Shenglin

机构信息

Department of Radiation Oncology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou First People's Hospital, Hangzhou, Zhejiang, China.

Department of Radiation Oncology, Hangzhou Cancer Hospital, Nanjing Medical University, Hangzhou, Zhejiang, China.

出版信息

Asia Pac J Clin Oncol. 2020 Aug;16(4):266-272. doi: 10.1111/ajco.13331. Epub 2020 Apr 14.

DOI:10.1111/ajco.13331

PMID:32285607

Abstract

AIM

To evaluate the role of radiotherapy (RT) in the treatment of localized primary adult rhabdomyosarcoma (RMS).

METHODS

This retrospective study identified 62 consecutive adult patients with localized primary RMS from January 2000 and July 2016. Local failure-free survival (LFFS), distant metastasis-free survival (DMFS) and overall survival (OS) were analyzed by the Kaplan-Meier method. Multivariate Cox proportional hazards regression models were fit to assess the ability of patient characteristics to predict survival.

RESULTS

With a median follow-up of 33 months (range, 6-195 months), the 5-year LFFS, DMFS and OS of all patients were 64.0%, 50.0% and 45.0%, respectively. RT was administered to 28 patients (45.2%). Patients who received RT had a higher 5-year LFFS (81.7% vs 47.2%), 5-year DMFS (59.4% vs 43.1%) and 5-year OS (57.1% vs 34.8%) compared with patients who did not received RT. In mulitvariate analysis, RT retained significance as an independent predictor of improved LFFS [hazard ratio (HR) = 0.282; 95% confidence interval (CI), 0.095-0.838; P = 0.023], DMFS (HR = 0.289; 95% CI, 0.125-0.991; P = 0.004) and OS (HR = 0.334; 95% CI, 0.153-0.727; P = 0.006).

CONCLUSIONS

RT significantly reduced local recurrence, distant metastasis and tumor mortality compared with no radiotherapy for localized primary adult RMS.

摘要

目的

评估放射治疗（RT）在局限性原发性成人横纹肌肉瘤（RMS）治疗中的作用。

方法

这项回顾性研究纳入了2000年1月至2016年7月期间连续62例局限性原发性成人RMS患者。采用Kaplan-Meier法分析局部无复发生存率（LFFS）、远处无转移生存率（DMFS）和总生存率（OS）。拟合多变量Cox比例风险回归模型以评估患者特征预测生存的能力。

结果

中位随访时间为33个月（范围6 - 195个月），所有患者的5年LFFS、DMFS和OS分别为64.0%、50.0%和45.0%。28例患者（45.2%）接受了RT。与未接受RT的患者相比，接受RT的患者5年LFFS更高（81.7%对47.2%），5年DMFS更高（59.4%对43.1%），5年OS更高（57.1%对34.8%）。在多变量分析中，RT作为LFFS改善的独立预测因素仍具有显著性[风险比（HR）= 0.282；95%置信区间（CI），0.095 - 0.838；P = 0.023]，DMFS（HR = 0.289；95% CI，0.125 - 0.991；P = 0.004）和OS（HR = 0.334；95% CI，0.153 - 0.727；P = 0.006）。