Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-Sho Sunto-Gun, Shimonagakubo Shizuoka, 1007411-8777, Japan.
Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
Invest New Drugs. 2022 Apr;40(2):411-419. doi: 10.1007/s10637-021-01183-6. Epub 2021 Oct 30.
In patients with limited disease small cell lung cancer (LD-SCLC) treated with concurrent chemoradiotherapy (CCRT), long-term survival data have not been fully evaluated. Moreover, the association between long-term prognosis and prognostic factors has not been sufficiently investigated.
In this retrospective study, we evaluated the efficacy of CCRT in 120 patients with LD-SCLC with a plan for curative CRT using concurrent accelerated hyperfractionated radiotherapy.
The patients had a median age of 65.5 years, predominantly male (73%), and had clinical stage III disease (80%). The median follow-up time for overall survival (OS) was 72.2 months, median OS was 42.5 months, and the 3-year and 5-year survival rates were 52.4% and 41.8%, respectively. The median progression-free survival (PFS) was 12.5 months, and the 3-year and 5-year PFS rates were 37.6% and 33.6%, respectively. The 5-year OS rates of patients who achieved PFS at each time point were 70.9%, 83.6%, and 91.9% at 12, 24, and 36 months, respectively. The gradual increase in the 5-year OS rate following PFS extension and initial depression of the Kaplan-Meier curve showed disease progression frequently occurred in the first 2 years after initiation of CCRT. The Cox proportional hazards model showed no significant factors correlated with long-term survival through univariate and multivariate analyses. Although the prognostic factors associated with long-term prognosis in LD-SCLC were not identified, the 5-year survival rate was 41.8%, and among patients without disease progression at 2 years, the 5-year survival rate was 83.6%.
These data suggested that the prognosis of patients with LD-SCLC was improving.
在接受同步放化疗（CCRT）治疗的局限性小细胞肺癌（LD-SCLC）患者中，尚未充分评估长期生存数据。此外，长期预后与预后因素之间的关联尚未得到充分研究。
在这项回顾性研究中，我们评估了 120 例接受计划根治性 CRT 的 LD-SCLC 患者接受同步加速超分割放疗的 CCRT 疗效。
患者的中位年龄为 65.5 岁，主要为男性（73%），临床分期为 III 期（80%）。总生存期（OS）的中位随访时间为 72.2 个月，中位 OS 为 42.5 个月，3 年和 5 年生存率分别为 52.4%和 41.8%。中位无进展生存期（PFS）为 12.5 个月，3 年和 5 年 PFS 率分别为 37.6%和 33.6%。在每个时间点达到 PFS 的患者的 5 年 OS 率分别为 12、24 和 36 个月时的 70.9%、83.6%和 91.9%。PFS 延长后和 Kaplan-Meier 曲线初始下降后 5 年 OS 率逐渐升高，表明 CCRT 开始后 2 年内疾病经常进展。Cox 比例风险模型显示，单因素和多因素分析均未发现与长期生存相关的显著因素。虽然未确定与 LD-SCLC 长期预后相关的预后因素，但 5 年生存率为 41.8%，在 2 年内无疾病进展的患者中，5 年生存率为 83.6%。
这些数据表明 LD-SCLC 患者的预后正在改善。
