Department of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Hidaka, Japan.
Thorac Cancer. 2021 Jan;12(2):245-250. doi: 10.1111/1759-7714.13764. Epub 2020 Dec 1.
Durvalumab after concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (LA-NSCLC) has been found to significantly improve overall survival (OS). However, the effect of durvalumab on local control remains unclear. Here, we evaluated the effect of the durvalumab on local control in comparison with the clinical result of patients treated with CCRT alone.
A total of 120 LA-NSCLC patients including 76 patients with CCRT alone and 44 patients with CCRT followed by durvalumab were analyzed. Baseline patient characteristics of CCRT alone cohort and durvalumab cohort were compared with student's t test or Mann-Whitney U test for continuous variables and with chi-squared test for categorical variables. Local control (LC), progression free survival (PFS) and OS rates were estimated using the Kaplan-Meier method and compared with the log-rank test.
There were 19 patients with stage II disease and 101 patients with stage III disease. Age, sex, histopathological type, T classification, N classification, clinical stage, tumor volume and dose fractionation schedule were not significantly different between the CCRT alone and durvalumab cohorts. The one-year LC rate was significantly higher in the durvalumab cohort (86%) compared with the CCRT alone cohort (62%) (P = 0.005), whereas no significant difference was observed in either PFS (P = 0.864) or OS (P = 0.443) between the CCRT and durvalumab cohorts.
The one-year LC rate was significantly higher in the durvalumab cohort compared with the CCRT alone cohort. Although the follow-up period was too short to draw definitive conclusions, the study revealed that durvalumab might have a significant effect on LC.
SIGNIFICANT FINDINGS OF THE STUDY: Effect of durvalumab on local control after chemoradiotherapy for locally advanced non-small cell lung cancer is unclear WHAT THIS STUDY ADDS: The one-year local control rate of chemoradiotherapy followed by durvalumab was significantly higher compared with chemoradiotherapy alone.
在局部晚期非小细胞肺癌（LA-NSCLC）中，同步放化疗（CCRT）后使用度伐鲁单抗可显著提高总生存期（OS）。然而，度伐鲁单抗对局部控制的影响尚不清楚。在这里，我们评估了度伐鲁单抗与单纯 CCRT 治疗患者的临床结果相比对局部控制的影响。
共分析了 120 例 LA-NSCLC 患者，其中 76 例接受单纯 CCRT 治疗，44 例接受 CCRT 后序贯度伐鲁单抗治疗。采用学生 t 检验或曼-惠特尼 U 检验比较 CCRT 单药组和度伐鲁单抗组的基线患者特征，采用卡方检验比较分类变量。采用 Kaplan-Meier 法估计局部控制（LC）、无进展生存期（PFS）和总生存期（OS）率，并采用对数秩检验比较。
有 19 例患者为 II 期，101 例患者为 III 期。年龄、性别、组织病理学类型、T 分类、N 分类、临床分期、肿瘤体积和剂量分割方案在 CCRT 单药组和度伐鲁单抗组之间无显著差异。度伐鲁单抗组的一年 LC 率（86%）显著高于 CCRT 单药组（62%）（P = 0.005），而 CCRT 组和度伐鲁单抗组之间在 PFS（P = 0.864）或 OS（P = 0.443）方面无显著差异。
与单纯 CCRT 组相比，度伐鲁单抗组的一年 LC 率显著更高。尽管随访时间太短，无法得出明确结论，但该研究表明，度伐鲁单抗可能对 LC 有显著影响。
度伐鲁单抗对局部晚期非小细胞肺癌放化疗后局部控制的影响尚不清楚。
与单纯放化疗相比，放化疗后序贯度伐鲁单抗的一年局部控制率显著提高。
