[立体定向体部放疗治疗早期非小细胞肺癌患者的预后分析]
[Prognosis Analysis of Early-stage Non-small Cell Lung Cancer Patients Treated with Stereotactic Body Radiotherapy].
作者信息
Yu Lu, Li Junyi, Gao Miaomiao, Wang Xiaofeng, Bai Hui, Guan Yong, Yuan Zhiyong
机构信息
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
出版信息
Zhongguo Fei Ai Za Zhi. 2023 Apr 20;26(4):274-280. doi: 10.3779/j.issn.1009-3419.2023.102.13.
BACKGROUND
With the aging of the population and the increased importance of lung cancer screening, the number of early-stage lung cancer patients has been on the rise in recent years, which can be classified into operable early-stage lung cancer and inoperable early-stage lung cancer. The most common pathological type is non-small cell lung cancer (NSCLC). Stereotactic body radiation therapy (SBRT) is the optimal treatment for inoperable early-stage NSCLC. The aim of this study was to investigate the prognosis of early-stage NSCLC patients treated with SBRT and its influencing factors in order to reduce the side effects of radiotherapy and improve the survival and quality of life.
METHODS
Clinical data and follow-up outcomes of early-stage NSCLC patients treated with SBRT in our hospital from August 2010 to August 2020 were collected. Kaplan-Meier method was used to assess the prognosis, and the Cox proportional risk model was used for multivariate prognostic analysis.
RESULTS
A total of 165 patients were included with a median follow-up time of 43.2 (range: 4.8-132.1) mon. The local control (LC) rates at 1-yr, 2-yr and 5-yr were 98.1%, 94.8% and 86.5% respectively. Karnofsky performance status (KPS) score greater than 80 was an independent prognostic factor for LC (P=0.02). The overall survival (OS) rates at 1-yr, 2-yr and 5-yr were 97.6%, 93.0% and 68.9% respectively. A biological equivalent dose when α/β=10 (BED10) greater than 132 Gy was an independent prognostic factor for OS (P=0.04). Progression-free survival (PFS) rates at 1-yr, 2-yr and 5-yr were 93.3%, 79.5% and 55.3% respectively. The distance metastasis free survival (DMFS) rates at 1-yr, 2-yr and 5-yr were 94.5%, 83.2% and 58.4% respectively. BED10 greater than 150 Gy was an independent prognostic factor for DMFS (P=0.02). The regional control (RC) rates at 1-yr, 2-yr and 5-yr were 98.8%, 95.4% and 87.9% respectively.
CONCLUSIONS
SBRT is effective in treating early-stage NSCLC. KPS greater than 80 is an independent prognostic factor for LC; BED10 greater than 132 Gy is an independent prognostic factor for OS; BED10 greater than 150 Gy is an independent prognostic factor for DMFS.
背景
随着人口老龄化以及肺癌筛查重要性的增加，近年来早期肺癌患者数量不断上升，早期肺癌可分为可手术的早期肺癌和不可手术的早期肺癌。最常见的病理类型是非小细胞肺癌（NSCLC）。立体定向体部放射治疗（SBRT）是不可手术的早期NSCLC的最佳治疗方法。本研究旨在探讨接受SBRT治疗的早期NSCLC患者的预后及其影响因素，以减少放疗副作用，提高生存率和生活质量。
方法
收集2010年8月至2020年8月在我院接受SBRT治疗的早期NSCLC患者的临床资料和随访结果。采用Kaplan-Meier法评估预后，Cox比例风险模型进行多因素预后分析。
结果
共纳入165例患者，中位随访时间为43.2（范围：4.8 - 132.1）个月。1年、2年和5年的局部控制（LC）率分别为98.1%、94.8%和86.5%。卡诺夫斯基功能状态（KPS）评分大于80是LC的独立预后因素（P = 0.02）。1年、2年和5年的总生存（OS）率分别为97.6%、93.0%和68.9%。当α/β = 10时的生物等效剂量（BED10）大于132 Gy是OS的独立预后因素（P = 0.04）。1年、2年和5年的无进展生存（PFS）率分别为93.3%、79.5%和55.3%。1年、2年和5年的无远处转移生存（DMFS）率分别为94.5%、83.2%和58.4%。BED10大于150 Gy是DMFS的独立预后因素（P = 0.02）。1年、2年和5年的区域控制（RC）率分别为98.8%、95.4%和87.9%。
结论
SBRT治疗早期NSCLC有效。KPS大于80是LC的独立预后因素；BED10大于132 Gy是OS的独立预后因素；BED10大于150 Gy是DMFS的独立预后因素。
Zotero 插件