Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.
Jpn J Radiol. 2021 Jun;39(6):611-617. doi: 10.1007/s11604-021-01091-y. Epub 2021 Jan 23.
To evaluate the differences in patterns of recurrence and treatment results by histology after definitive radiotherapy for stage III non-small cell lung cancer (NSCLC) in Japan.
Patients with stage III NSCLC who underwent definitive radiotherapy between 2000 and 2016 in our institution were included. A total of 217 patients were enrolled. Propensity score matching was used to exclude the following confounding factors: (1) age (≥70 years or <70 years), (2) gender, (3) T factor, (4) N factor, (5) Eastern Cooperative Oncology Group performance status score and (6) smoking status (Brinkman index ≥400 or <400).
The median observation period for survivors was 55.1 months. After propensity score matching, the Sqcc and adenocarcinoma groups each included 62 paired patients. There was no significant difference in OS or PFS between the adenocarcinoma and Sqcc groups. However, rates of recurrence in the GTV-primary site (p = 0.009) and GTV-lymph node site (p = 0.037) were significantly higher in patients with Sqcc than in patients with adenocarcinoma. New metastatic recurrence was more frequent in patients with adenocarcinoma than in patients with Sqcc (p = 0.025).
There were significant differences in patterns of recurrence after definitive (chemo)radiotherapy between patients with Sqcc and patients with adenocarcinoma.
评估日本根治性放疗后Ⅲ期非小细胞肺癌(NSCLC)不同组织学类型的复发模式和治疗结果。
本研究纳入了 2000 年至 2016 年期间在我院接受根治性放疗的Ⅲ期 NSCLC 患者。共纳入 217 例患者。采用倾向评分匹配排除以下混杂因素:(1)年龄(≥70 岁或<70 岁);(2)性别;(3)T 分期;(4)N 分期;(5)东部肿瘤协作组体力状态评分;(6)吸烟状况(Brinkman 指数≥400 或<400)。
幸存者的中位观察期为 55.1 个月。经过倾向评分匹配后,腺癌组和鳞癌组各包含 62 对患者。腺癌和鳞癌组之间的总生存期(OS)或无进展生存期(PFS)无显著差异。然而,鳞癌患者的 GTV-原发灶(p=0.009)和 GTV-淋巴结灶(p=0.037)的复发率显著高于腺癌患者。腺癌患者的新发转移复发率高于鳞癌患者(p=0.025)。
根治性(放)化疗后,鳞癌和腺癌患者的复发模式存在显著差异。