Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China; Department of Radiation Oncology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, China.
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China.
Radiother Oncol. 2021 Jun;159:218-223. doi: 10.1016/j.radonc.2021.03.026. Epub 2021 Mar 30.
In previous studies, the estimated dose of radiation to immune cells (EDRIC) showed a correlation with overall survival (OS) of patients with locally advanced non-small cell lung cancer (LA-NSCLC) who received thoracic radiotherapy. However, several factors such as gross tumor volume (GTV) and lymph node (N) stage may impact EDRIC. The purpose of this study was to identify the factors influencing EDRIC and to further assess the prognostic relevance of EDRIC.
We retrospectively analyzed 201 patients with LA-NSCLC who received radiotherapy between 2012 and 2017. EDRIC was calculated based on the model developed by Jin et al. Kaplan-Meier method and Cox proportional hazards regression were used to analyze the correlation of potential factors with OS, local progression-free survival (LPFS), and distant metastasis-free survival (DMFS). Spearman's rank correlation was used to assess the correlation between variables.
Both GTV and N stage showed a positive correlation with EDRIC (r = 0.347, P < 0.001 and r = 0.249, P < 0.001, respectively). EDRIC was independently associated with DMFS (HR 1.185, P < 0.001). GTV was associated with OS (HR 1.006, P < 0.001), LPFS (HR 1.003, P = 0.017), and DMFS (HR 1.003, P = 0.032). While using GTV as a stratification factor in Kaplan-Meier analysis, EDRIC showed a trend of negative correlation with OS in GTV ≤ 66.6 cm group (P = 0.061).
EDRIC was an independent prognostic factor for metastasis and it was affected by GTV and N stage. However, the effect of EDRIC on OS was influenced by GTV.
在之前的研究中，免疫细胞接受的辐射剂量（EDRIC）与接受胸部放射治疗的局部晚期非小细胞肺癌（LA-NSCLC）患者的总生存期（OS）相关。然而，一些因素如肿瘤靶区（GTV）和淋巴结（N）分期可能会影响 EDRIC。本研究的目的是确定影响 EDRIC 的因素，并进一步评估 EDRIC 的预后相关性。
我们回顾性分析了 2012 年至 2017 年间接受放疗的 201 例 LA-NSCLC 患者。根据 Jin 等人建立的模型计算 EDRIC。采用 Kaplan-Meier 法和 Cox 比例风险回归分析潜在因素与 OS、局部无进展生存期（LPFS）和无远处转移生存期（DMFS）的相关性。采用 Spearman 秩相关评估变量之间的相关性。
GTV 和 N 分期均与 EDRIC 呈正相关（r=0.347，P<0.001 和 r=0.249，P<0.001）。EDRIC 与 DMFS 独立相关（HR 1.185，P<0.001）。GTV 与 OS（HR 1.006，P<0.001）、LPFS（HR 1.003，P=0.017）和 DMFS（HR 1.003，P=0.032）相关。在 Kaplan-Meier 分析中使用 GTV 作为分层因素时，EDRIC 在 GTV≤66.6cm 组中与 OS 呈负相关趋势（P=0.061）。
EDRIC 是转移的独立预后因素，受 GTV 和 N 分期的影响。然而，EDRIC 对 OS 的影响受 GTV 影响。
