Yang Yan, Li Gaohua, Li Shuyuan, Wang Yuanhang, Zhao Yanbo, Dong Baiqiang, Wang Jin, Zhu Ruiwu, Chen Ming
Department of Radiation Oncology, General Hospital of Fushun Mining Bureau of Liaoning Health Industry Group, Fushun, China.
Department of Medical Oncology, General Hospital of Fushun Mining Bureau of Liaoning Health Industry Group, Fushun, China.
Front Oncol. 2021 Oct 11;11:746785. doi: 10.3389/fonc.2021.746785. eCollection 2021.
Computed tomography (CT) appearance pattern after lung tumor stereotactic body radiation therapy(SBRT) might predicts survival. This study aimed to investigate the correlation between CT appearance pattern after SBRT and outcomes in patients with early-stage non-small-cell lung cancer (NSCLC).
Clinical data of inoperable patients with early-stage NSCLC undergoing SBRT were retrospectively analyzed from 2012 to 2015 at the Zhejiang Cancer Hospital. The relationship between CT appearance pattern after SBRT and patient's survival was analyzed.
The data from 173 patients with early-stage lung cancer treated with SBRT were analyzed. One month after SBRT, diffuse consolidation was seen in 17 patients, patchy consolidation in 28 patients, diffuse ground-glass opacity (GGO) in 10 patients, and patchy GGO in 22 patients. The survival time was significantly longer in the "no evidence of increased density" group compared with the "consolidation or GGO" group [2-year overall survival (OS) rate, 96.1% vs 89.3%; hazard ratio (HR), 0.36; 95% confidence interval (CI), 0.16-0.85; = 0.015]. A similar trend was found in the progression-free survival (PFS) analysis (2-year PFS rate, 91.3% vs 85.0%; HR, 0.35; 95% CI, 0.13-0.95; = 0.015) and distant metastasis free survival(DMFS) (2-year DMFS rate, 93.3% vs 87.1%; HR, 0.41; 95% CI, 0.20-0.86; = 0.031). However, no significant difference was found in recurrence-free survival between the two groups ( = 0.212).
One month after SBRT, the radiological change "no evidence of increased density" was prevalent. The OS, PFS, and DMFS were significantly longer in the "no evidence of increased density" group compared with the "consolidation or GGO" group. Further studies are needed to validate these findings.
肺肿瘤立体定向体部放疗（SBRT）后的计算机断层扫描（CT）表现模式可能预测生存情况。本研究旨在探讨SBRT后CT表现模式与早期非小细胞肺癌（NSCLC）患者预后之间的相关性。
回顾性分析2012年至2015年在浙江省肿瘤医院接受SBRT的无法手术的早期NSCLC患者的临床资料。分析SBRT后CT表现模式与患者生存之间的关系。
分析了173例接受SBRT治疗的早期肺癌患者的数据。SBRT后1个月，17例出现弥漫性实变，28例出现斑片状实变，10例出现弥漫性磨玻璃影（GGO），22例出现斑片状GGO。“无密度增加证据”组的生存时间明显长于“实变或GGO”组[2年总生存（OS）率，96.1%对89.3%；风险比（HR），0.36；95%置信区间（CI），0.16 - 0.85；P = 0.015]。在无进展生存（PFS）分析中发现了类似趋势（2年PFS率，91.3%对85.0%；HR，0.35；95% CI，0.13 - 0.95；P = 0.015）以及无远处转移生存（DMFS）（2年DMFS率，93.3%对87.1%；HR，0.41；95% CI，0.20 - 0.86；P = 0.031）。然而，两组之间的无复发生存率无显著差异（P = 0.212）。
SBRT后1个月，“无密度增加证据”的放射学改变较为普遍。“无密度增加证据”组的OS、PFS和DMFS明显长于“实变或GGO”组。需要进一步研究来验证这些发现。
