Department of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan;
Department of Radiation Oncology, International Medical Center, Saitama Medical University, Hidaka, Japan.
Anticancer Res. 2023 Feb;43(2):675-682. doi: 10.21873/anticanres.16205.
BACKGROUND/AIM: Efficacy and toxicity of concurrent chemoradiotherapy (CCRT) and durvalumab for locally advanced non-small cell lung cancer (LA-NSCLC) with N3 lymph node metastasis remain unclear. We aimed to evaluate the clinical outcomes of patients who received CCRT and durvalumab (durvalumab cohort) and compare their outcomes with those of patients who received CCRT alone (CCRT-alone cohort).
The data of patients who had received treatment between November 2008 and February 2022 and were followed up for at least 3 months were retrospectively analyzed. Local control, progression-free survival, and overall survival were evaluated using Kaplan-Meier analysis and compared using the log-rank test. Toxicity was evaluated using the Common Terminology Criteria for Adverse Events version 5.0.
The data of 29 patients were analyzed (median follow-up period: 22 months). Among them, 17 received CCRT alone and 12 received CCRT and durvalumab. There were 14 patients with stage IIIB and 15 with stage IIIC LA-NSCLC. The durvalumab cohort (89%) had a significantly higher 1-year local control rate than the CCRT-alone cohort (47%; p=0.035). No significant difference was observed in either progression-free or overall survival between the two cohorts. Grade ≥2 pneumonitis was observed in 6 (50%) and 7 (41%) patients in the durvalumab and CCRT-alone cohorts, respectively.
CCRT with durvalumab may be effective against LA-NSCLC with N3 lymph node metastasis. The incidence of grade 2 pneumonitis was slightly higher in the durvalumab cohort than in the CCRT-alone cohort, suggesting the need for careful patient monitoring after treatment.
背景/目的：同步放化疗（CCRT）联合 durvalumab 治疗伴有 N3 淋巴结转移的局部晚期非小细胞肺癌（LA-NSCLC）的疗效和毒性尚不清楚。我们旨在评估接受 CCRT 和 durvalumab 治疗的患者的临床结果（durvalumab 组），并将其结果与接受单纯 CCRT 治疗的患者（CCRT 组）进行比较。
回顾性分析了 2008 年 11 月至 2022 年 2 月期间接受治疗并至少随访 3 个月的患者的数据。采用 Kaplan-Meier 分析评估局部控制、无进展生存期和总生存期，并采用对数秩检验进行比较。采用不良事件通用术语标准 5.0 评估毒性。
共分析了 29 例患者（中位随访时间：22 个月）。其中，17 例患者接受单纯 CCRT，12 例患者接受 CCRT 联合 durvalumab。14 例患者为 IIIB 期，15 例患者为 IIIC 期 LA-NSCLC。durvalumab 组（89%）的 1 年局部控制率显著高于 CCRT 组（47%；p=0.035）。两组间无进展生存期或总生存期无显著差异。durvalumab 组和 CCRT 组分别有 6 例（50%）和 7 例（41%）患者发生 2 级以上肺炎。
CCRT 联合 durvalumab 可能对伴有 N3 淋巴结转移的 LA-NSCLC 有效。durvalumab 组 2 级肺炎的发生率略高于 CCRT 组，提示治疗后需要密切监测患者。
