Katz Leah M, Ng Victor, Wu S Peter, Yan Sherry, Grew David, Shin Samuel, Colangelo Nicholas W, McCarthy Allison, Pass Harvey I, Chachoua Abraham, Schiff Peter B
Department of Radiation Oncology, New York University (NYU) Langone Health, Perlmutter Cancer Center, New York, NY, United States.
Department of Cardiothoracic Surgery, New York University (NYU) Langone Health, Perlmutter Cancer Center, New York, NY, United States.
Front Oncol. 2022 May 24;12:870143. doi: 10.3389/fonc.2022.870143. eCollection 2022.
To investigate the efficacy and safety of lung stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC) including oligorecurrent and oligoprogressive disease.
Single-institution retrospective analysis of 60 NSCLC patients with 62 discrete lesions treated with SBRT between 2008 and 2017. Patients were stratified into three groups, including early stage, locally recurrent, and oligoprogressive disease. Group 1 included early stage local disease with no prior local therapy. Group 2 included locally recurrent disease after local treatment of a primary lesion, and group 3 included regional or well-controlled distant metastatic disease receiving SBRT for a treatment naive lung lesion (oligoprogressive disease). Patient/tumor characteristics and adverse effects were recorded. Local failure free survival (LFFS), progression free survival (PFS), and overall survival (OS) were estimated using the Kaplan Meier method.
At median follow-up of 34 months, 67% of the study population remained alive. The estimated 3-year LFFS for group 1, group 2, and group 3 patients was 95% (95% CI: 86%-100%), 82%(62% - 100%), and 83% (58-100%), respectively. The estimated 3-year PFS was 59% (42-83%), 40% (21%-78%), and 33% (12%-95%), and the estimated 3-year OS was 58% (41-82%), 60% (37-96%), and 58% (31-100%)), respectively for each group. When adjusted for age and size of lesion, no significant difference in OS, LFFS, and PFS emerged between groups (p > 0.05). No patients experienced grade 3 to 5 toxicity. Eighteen patients (29%) experienced grade 1 to 2 toxicity. The most common toxicities reported were cough and fatigue.
Our data demonstrates control rates in group 1 patients comparable to historical controls. Our study also reveals comparable clinical results for SBRT in the treatment of NSCLC by demonstrating similar rates of LFFS and OS in group 2 and group 3 patients with locally recurrent and treatment naïve lung lesion with well-controlled distant metastatic disease.
研究立体定向体部放疗（SBRT）治疗非小细胞肺癌（NSCLC）的疗效和安全性，包括寡复发和寡进展性疾病。
对2008年至2017年间接受SBRT治疗的60例NSCLC患者的62个离散病灶进行单机构回顾性分析。患者被分为三组，包括早期、局部复发和寡进展性疾病。第1组包括未经局部治疗的早期局部疾病。第2组包括原发性病灶局部治疗后的局部复发性疾病，第3组包括接受SBRT治疗未经治疗的肺部病灶（寡进展性疾病）的区域或远处转移控制良好的疾病。记录患者/肿瘤特征和不良反应。采用Kaplan-Meier法估计局部无复发生存率（LFFS）、无进展生存率（PFS）和总生存率（OS）。
中位随访34个月时，67%的研究人群仍存活。第1组、第2组和第3组患者的3年LFFS估计分别为95%（95%CI：86%-100%）、82%（62%-100%）和83%（58%-100%）。估计3年PFS分别为59%（42%-83%）、40%（21%-78%）和33%（12%-95%），估计3年OS分别为58%（41%-82%）、60%（37%-96%）和58%（31%-100%）。在调整年龄和病灶大小后，各组之间的OS、LFFS和PFS无显著差异（p>0.05）。没有患者出现3至5级毒性反应。18例患者（29%）出现1至2级毒性反应。报告的最常见毒性反应是咳嗽和疲劳。
我们的数据表明，第1组患者的控制率与历史对照相当。我们的研究还显示，SBRT在治疗NSCLC方面具有可比的临床结果，第2组和第3组局部复发和未经治疗的肺部病灶且远处转移控制良好的患者的LFFS和OS率相似。
