Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Department of Radiology, Ehime University Graduate School of Medicine, Toon, Japan.
Thorac Cancer. 2023 Jul;14(19):1795-1801. doi: 10.1111/1759-7714.14903. Epub 2023 May 29.
This study aimed to devise a simple assessment system for bone metastases (BMs) from lung cancer (LC).
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.
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).
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.
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。
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。
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)。
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。