Phase I Clinical Trial Ward, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou, China.
Dr.Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau (S.A.R.), China.
Medicine (Baltimore). 2022 Nov 18;101(46):e31918. doi: 10.1097/MD.0000000000031918.
Oligometastatic non-small-cell lung cancer (NSCLC) is potentially curable. Oligo-recurrence occurs with oligometastatic disease characterized by well-controlled primary lesion. The purpose of the present study was to explore the value of definitive local therapy (DLT) for extracranial single-organ oligorecurrent NSCLC. A total of 81 patients with NSCLC who had extracranial single-organ oligorecurrence after receiving radical treatment at the Cancer Hospital of the University of Chinese Academy of Sciences from January 2010 to December 2017 were analyzed. The primary endpoint was progression-free survival (PFS), and the secondary endpoint was overall survival (OS). The median follow-up time of the 81 patients was 65.8 months. A total of 39 patients received DLT. A large proportion of patients who did not accept DLTs received specific tyrosine kinase inhibitors (TKIs). The results of multivariate analysis showed that DLT and specific TKI therapy were favorable prognostic factors significantly related to PFS. Further analysis showed that for patients without specific TKI therapy, DLT significantly improved PFS and the 5-year PFS rate. The 5-year OS rate also improved, but the improvement was not significant. For extracranial single-organ oligorecurrent NSCLC, PFS was significantly superior in patients receiving DLT. Among them, for the subgroup of patients who did not receive specific TKI therapy, DLT is expected to improve long-term prognostic outcomes.
寡转移非小细胞肺癌（NSCLC）具有潜在可治愈性。寡转移疾病表现为原发灶得到良好控制的情况下出现寡复发。本研究旨在探讨根治性治疗后发生单一器官寡复发的 NSCLC 患者行确定性局部治疗（DLT）的价值。
回顾性分析 2010 年 1 月至 2017 年 12 月在中国科学院大学附属肿瘤医院接受根治性治疗后发生单一器官寡转移复发的 NSCLC 患者 81 例，所有患者均为首次复发，且为单一器官复发，仅接受过根治性治疗，无局部或远处转移证据。主要终点为无进展生存期（PFS），次要终点为总生存期（OS）。81 例患者的中位随访时间为 65.8 个月。39 例患者接受了 DLT。未接受 DLT 治疗的患者中，大部分接受了特定的酪氨酸激酶抑制剂（TKI）治疗。多因素分析结果显示，DLT 和特定 TKI 治疗是与 PFS 显著相关的有利预后因素。进一步分析显示，对于未接受特定 TKI 治疗的患者，DLT 可显著改善 PFS 和 5 年 PFS 率，5 年 OS 率也有所提高，但差异无统计学意义。对于发生单一器官寡复发的 NSCLC 患者，接受 DLT 治疗的患者 PFS 明显更好。其中，对于未接受特定 TKI 治疗的亚组患者，DLT 有望改善长期预后结局。
