Abdalmassih Michael, Bucher Oliver, Rathod Shrinivas, Dubey Arbind, Kim Julian O, Ahmed Naseer, Leylek Ahmet, Chowdhury Amitava, Bashir Bashir
Family Medicine, University of Manitoba, Winnipeg, CAN.
Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, CAN.
Cureus. 2020 Dec 3;12(12):e11886. doi: 10.7759/cureus.11886.
Introduction The standard of care for early-stage non-small cell lung cancer (NSCLC) is surgery. However, for medical inoperable patients stereotactic body radiation therapy (SBRT) is an alternative method. The aim of the study is to assess the overall survival (OS), progression-free survival (PFS) and local control (LC) of patients diagnosed with NSCLC in Manitoba, Canada, between 2013 and 2017 and managed with SBRT. Materials and methods This retrospective study included a total of 158 patients (60.13% of the population were females) that were diagnosed with stage I-II NSCLC and were treated with lung SBRT between 2013 and 2017 in Manitoba. Demographics and clinical data were retrospectively extracted from the electronic patient record. Kaplan-Meier and Cumulative incidence curves were used to describe the OS, PFS, and LC outcomes. Results From the 158 patients, 32 patients were treated with 60 Gy in eight fractions, while 121 patients were treated with 48 Gy in four fractions. Only 85 patients had biopsy-proven NSCLC. The median OS was 2.87 years (95% confidence interval [CI] 2.16-3.43). OS rates at one and two years were 85% and 66%, respectively. The median PFS was 2.03 years (95% CI 1.65-2.77). Furthermore, one-year and two-year PFS rates were 77% and 51%, respectively. Only 10 patients progressed locally at one year and 17 at two years, making the LC rate 93% at the one-year and 87% at the two-year mark. Conclusion These findings add to a growing evidence base supporting SBRT in the treatment of clinically suspected and biopsy-proven early-stage NSCLC patients.
引言 早期非小细胞肺癌(NSCLC)的标准治疗方法是手术。然而,对于无法进行手术的患者,立体定向体部放射治疗(SBRT)是一种替代方法。本研究的目的是评估2013年至2017年在加拿大曼尼托巴省被诊断为NSCLC并接受SBRT治疗的患者的总生存期(OS)、无进展生存期(PFS)和局部控制率(LC)。
材料和方法 这项回顾性研究共纳入了158例患者(60.13%为女性),这些患者在2013年至2017年期间在曼尼托巴省被诊断为I-II期NSCLC并接受了肺部SBRT治疗。人口统计学和临床数据是从电子病历中回顾性提取的。采用Kaplan-Meier法和累积发病率曲线来描述OS、PFS和LC结果。
结果 在这158例患者中,32例患者接受了8次分割共60 Gy的治疗,而121例患者接受了4次分割共48 Gy的治疗。只有85例患者经活检证实为NSCLC。中位OS为2.87年(95%置信区间[CI] 2.16-3.43)。1年和2年的OS率分别为85%和66%。中位PFS为2.03年(95% CI 1.65-2.77)。此外,1年和2年的PFS率分别为77%和51%。只有10例患者在1年时出现局部进展,17例在2年时出现局部进展,使得1年时的LC率为93%,2年时为87%。
结论 这些发现进一步充实了支持SBRT治疗临床疑似和活检证实的早期NSCLC患者的证据基础。