Chen Zhe, Nonaka Hotaka, Onishi Hiroshi, Nakatani Eiji, Oguri Mitsuhiko, Saito Masahide, Aoki Shinichi, Marino Kan, Komiyama Takafumi, Kuriyama Kengo, Araya Masayuki, Tominaga Licht, Saito Ryo, Maehata Yoshiyasu, Shinohara Ryoji
Department of Radiology, Shizuoka General Hospital, Shizuoka 420-8527, Japan.
Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan.
Cancers (Basel). 2022 Nov 30;14(23):5915. doi: 10.3390/cancers14235915.
We aimed to evaluate the impact of systemic autoimmune diseases (SADs) on treatment outcomes and radiation toxicities following stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC). We queried an institution-based database on patients with SADs treated with SBRT for lung cancer between 2001 and 2016 (SAD group). Each patient was matched to three controls without SADs. The primary outcomes of interest were the overall survival (OS) and local control rate (LCR). The secondary outcomes were radiation toxicities of grades ≥2 (≥G2). Twelve patients with SADs were matched to 36 controls. The median follow-up duration was 3.6 years. There was a significant intergroup difference in the OS (hazard ratio [HR]: 4.11, 95% confidence incidence [CI]: 1.82−9.27, p < 0.001) and LCR (HR: 15.97, 95% CI: 2.89−88.29, p < 0.001). However, there were no significant intergroup differences in the odds of acute (odds ratio [OR]: 0.38, 95% CI: 0.02−8.91, p = 0.550) and late (OR: 2.20, 95% CI: 0.32−15.10, p = 0.422) ≥G2 radiation pneumonitis. No other ≥G2 toxicities were identified. In conclusion, although radiation toxicities are not enhanced by SADs, SADs are risk factors of poor prognosis following SBRT for stage I NSCLC.
我们旨在评估全身自身免疫性疾病（SADs）对I期非小细胞肺癌（NSCLC）立体定向体部放疗（SBRT）后治疗结果和放射毒性的影响。我们查询了一个基于机构的数据库，该数据库收录了2001年至2016年间接受SBRT治疗肺癌的SADs患者（SAD组）。将每名患者与三名无SADs的对照进行匹配。感兴趣的主要结局是总生存期（OS）和局部控制率（LCR）。次要结局是≥2级（≥G2）的放射毒性。12名SADs患者与36名对照进行了匹配。中位随访时间为3.6年。OS（风险比[HR]：4.11，95%置信区间[CI]：1.82−9.27，p<0.001）和LCR（HR：15.97，95%CI：2.89−88.29，p<0.001）存在显著的组间差异。然而，急性（优势比[OR]：0.38，95%CI：0.02−8.91，p = 0.550）和晚期（OR：2.20，95%CI：0.32−15.10，p = 0.422）≥G2放射性肺炎的发生率在组间无显著差异。未发现其他≥G2毒性。总之，虽然SADs不会增加放射毒性，但SADs是I期NSCLC患者SBRT后预后不良的危险因素。
