Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Department of Radiology, Iwakuni Clinical Center.
Acta Med Okayama. 2021 Jun;75(3):269-277. doi: 10.18926/AMO/62218.
Palliative concurrent chemoradiotherapy (CCRT) is often administered to patients with stage III non-small cell lung cancer (NSCLC). We investigated the clinical outcomes of patients receiving palliative CCRT for NSCLC. Data of patients with NSCLC who underwent palliative CCRT (n=16), preoperative CCRT plus surgery (n=97), or definitive CCRT (n=48) were evaluated. In all groups, the concurrent chemotherapy regimens consisted of cisplatin and docetaxel. Rates of local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), overall survival (OS), and prognosis were compared. The 2-year rates of LC, DMFS, PFS, and OS in 16 patients who underwent palliative CCRT were 44.4%, 12.5%, 12.5%, and 18.8%, respectively. Univariate analysis showed that palliative CCRT was associated with poor LC (p<0.001), DMFS (p<0.001), PFS (p<0.001), and OS (p<0.001) outcomes in patients who completed CCRT as a preoperative treatment and poor LC (p=0.01), DMFS (p=0.003), PFS (p=0.04), and OS (p=0.004) outcomes in patients who were considered for definitive CCRT. Although there were some long-term survivors, the clinical outcomes of palliative CCRT were significantly inferior to those of the ideal treatments. Therefore, careful determination of the appropriate treatment indications and further studies are warranted.
姑息性同步放化疗(CCRT)常用于治疗 III 期非小细胞肺癌(NSCLC)患者。我们研究了接受 NSCLC 姑息性 CCRT 治疗的患者的临床结局。评估了接受姑息性 CCRT(n=16)、术前 CCRT 加手术(n=97)或根治性 CCRT(n=48)的 NSCLC 患者的数据。所有组的同步化疗方案均包括顺铂和多西他赛。比较了局部控制率(LC)、无远处转移生存(DMFS)、无进展生存(PFS)、总生存(OS)和预后。16 例接受姑息性 CCRT 的患者的 2 年 LC、DMFS、PFS 和 OS 率分别为 44.4%、12.5%、12.5%和 18.8%。单因素分析显示,姑息性 CCRT 与作为术前治疗完成 CCRT 的患者的 LC(p<0.001)、DMFS(p<0.001)、PFS(p<0.001)和 OS(p<0.001)结局差以及考虑进行根治性 CCRT 的患者的 LC(p=0.01)、DMFS(p=0.003)、PFS(p=0.04)和 OS(p=0.004)结局差相关。尽管有一些长期生存者,但姑息性 CCRT 的临床结局明显差于理想治疗。因此,需要仔细确定适当的治疗适应证,并进行进一步研究。