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一种用于预测接受姑息性放疗的骨转移肺癌患者生存情况的简便工具。

An easy tool to predict survival in patients with bone metastatic lung cancer treated with palliative radiotherapy.

机构信息

Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.

Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan.

出版信息

Thorac Cancer. 2023 Jul;14(19):1795-1801. doi: 10.1111/1759-7714.14903. Epub 2023 May 29.

Abstract

BACKGROUND

This study aimed to devise a simple assessment system for bone metastases (BMs) from lung cancer (LC).

METHODS

A total of 368 LC patients with BMs who underwent radiotherapy (RT) were retrospectively reviewed. Prognostic factors were evaluated using multivariate analysis, and a scoring system based on regression coefficients was devised.

RESULTS

The median follow-up time for survival was 4.3 months, and the 0.5-year overall survival (OS) rate was 44.7%. In the multivariate analysis, the significant prognostic factors were performance status (PS), metastases to internal organs, and post-RT molecular-targeting therapies (MTs) (tyrosine kinase inhibitors, and/or immune checkpoint inhibitors). A scoring system aggregating points assigned to each risk factor was created (2 points; non-administration of post-RT MTs, 1 point; PS ≥3 and metastases to internal organs). The median OSs were 25.0 months, 12.8 months, and 2.5 months in patients with a total score of 0 (n = 22), 1-2 (n = 124), and 3-4 (n = 221), respectively (p < 0.01).

CONCLUSION

This easy-to-use scoring system is useful for selecting patients who received comparatively high-dose fractionated RT for BMs from LC. Updates are required to follow the progress of systemic therapy.

摘要

背景

本研究旨在设计一种用于肺癌(LC)骨转移(BMs)的简单评估系统。

方法

回顾性分析了 368 例接受放射治疗(RT)的有 BMs 的 LC 患者。使用多变量分析评估预后因素,并基于回归系数设计了评分系统。

结果

生存随访时间的中位数为 4.3 个月,0.5 年总生存率(OS)为 44.7%。在多变量分析中,显著的预后因素是表现状态(PS)、内部器官转移和 RT 后分子靶向治疗(MTs)(酪氨酸激酶抑制剂和/或免疫检查点抑制剂)。创建了一个汇总每个危险因素得分的评分系统(2 分;未进行 RT 后 MTs 治疗,1 分;PS≥3 和内部器官转移)。总分为 0(n=22)、1-2(n=124)和 3-4(n=221)的患者中位 OS 分别为 25.0 个月、12.8 个月和 2.5 个月(p<0.01)。

结论

这个易于使用的评分系统可用于为 LC 的 BMs 患者选择接受相对高剂量分割 RT。需要更新以跟踪系统治疗的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9470/10317599/93d90bb6648c/TCA-14-1795-g003.jpg

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