国际早期肺癌行动计划（I-ELCAP）20 年随访研究。
A 20-year Follow-up of the International Early Lung Cancer Action Program (I-ELCAP).
机构信息
From the Department of Diagnostic, Molecular, and Interventional Radiology (C.I.H., R.Y., D.F.Y.), Institute of Translational Epidemiology (E.T.), and Department of Thoracic Surgery (R.M.F.), Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl, New York, NY 10029; Department of Radiology, Phoenix Veterans Affairs Health Care System, Phoenix, Ariz (C.I.H.); Department of Radiology, Hadassah Medical Center, Jerusalem, Israel (D.S.); Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel (D.S.); Barry Commoner Center for Health and the Environment, Queens College City University of New York, Queens, NY (S.M.); Department of Radiology, Fundación Instituto Valenciano de Oncología, Valencia, Spain (J.C.D.); Department of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai West, New York, NY (J.J.Z.); Department of Pulmonology, Clínica Universidad de Navarra, Pamplona, Spain (J.J.Z., L.M.S.); Department of Hematology and Oncology, Holy Cross Hospital Cancer Institute, Silver Spring, Md (C.A.); Department of Pulmonology and Sleep Medicine Clinic Hirslanden, LungenZentrum Hirslanden, Zurich, Switzerland (K.K.); Department of Thoracic Surgery, Mount Sinai South Nassau, Oceanside, NY (S.A.); Department of Thoracic Surgery, Montefiore St Luke's Cornwall, Cornwall, NY (C.C.); Departments of Pulmonology (J.P.S.) and Surgery (N.A.), Weill Cornell Medical College, New York, NY; and Department of Thoracic Surgery, Tisch Cancer Center, New York, NY (E.T.).
出版信息
Radiology. 2023 Nov;309(2):e231988. doi: 10.1148/radiol.231988.
Background The low-dose CT (≤3 mGy) screening report of 1000 Early Lung Cancer Action Program (ELCAP) participants in 1999 led to the International ELCAP (I-ELCAP) collaboration, which enrolled 31 567 participants in annual low-dose CT screening between 1992 and 2005. In 2006, I-ELCAP investigators reported the 10-year lung cancer-specific survival of 80% for 484 participants diagnosed with a first primary lung cancer through annual screening, with a high frequency of clinical stage I lung cancer (85%). Purpose To update the cure rate by determining the 20-year lung cancer-specific survival of participants diagnosed with first primary lung cancer through annual low-dose CT screening in the expanded I-ELCAP cohort. Materials and Methods For participants enrolled in the HIPAA-compliant prospective I-ELCAP cohort between 1992 and 2022 and observed until December 30, 2022, Kaplan-Meier survival analysis was used to determine the 10- and 20-year lung cancer-specific survival of participants diagnosed with first primary lung cancer through annual low-dose CT screening. Eligible participants were aged at least 40 years and had current or former cigarette use or had never smoked but had been exposed to secondhand tobacco smoke. Results Among 89 404 I-ELCAP participants, 1257 (1.4%) were diagnosed with a first primary lung cancer (684 male, 573 female; median age, 66 years; IQR, 61-72), with a median smoking history of 43.0 pack-years (IQR, 29.0-60.0). Median follow-up duration was 105 months (IQR, 41-182). The frequency of clinical stage I at pretreatment CT was 81% (1017 of 1257). The 10-year lung cancer-specific survival of 1257 participants was 81% (95% CI: 79, 84) and the 20-year lung cancer-specific survival was 81% (95% CI: 78, 83), and it was 95% (95% CI: 91, 98) for 181 participants with pathologic T1aN0M0 lung cancer. Conclusion The 10-year lung cancer-specific survival of 80% reported in 2006 for I-ELCAP participants enrolled in annual low-dose CT screening and diagnosed with a first primary lung cancer has persisted, as shown by the updated 20-year lung cancer-specific survival for the expanded I-ELCAP cohort. © RSNA, 2023 See also the editorials by Grenier and by Sequist and Olazagasti in this issue.
背景 1999 年，1000 名早期肺癌行动计划（ELCAP）参与者的低剂量 CT（≤3 毫戈瑞）筛查报告促成了国际 ELCAP（I-ELCAP）合作，该合作在 1992 年至 2005 年间招募了 31567 名参与者进行年度低剂量 CT 筛查。2006 年，I-ELCAP 研究人员报告称，通过年度筛查诊断出的 484 名首次原发性肺癌患者的 10 年肺癌特异性生存率为 80%，其中临床 I 期肺癌的频率较高（85%）。目的 通过确定通过年度低剂量 CT 筛查诊断出的首次原发性肺癌患者的 20 年肺癌特异性生存率，更新治愈率。材料和方法 对于 1992 年至 2022 年期间在 HIPAA 合规的前瞻性 I-ELCAP 队列中入组并观察至 2022 年 12 月 30 日的参与者，使用 Kaplan-Meier 生存分析来确定通过年度低剂量 CT 筛查诊断出的首次原发性肺癌患者的 10 年和 20 年肺癌特异性生存率。合格的参与者年龄至少为 40 岁，目前或曾经吸烟，或从未吸烟但曾接触过二手烟。结果 在 89404 名 I-ELCAP 参与者中，有 1257 人（1.4%）被诊断为首次原发性肺癌（684 名男性，573 名女性；中位年龄为 66 岁；IQR，61-72），中位吸烟史为 43.0 包年（IQR，29.0-60.0）。中位随访时间为 105 个月（IQR，41-182）。预处理 CT 时临床 I 期的频率为 81%（1257 名患者中的 1017 名）。1257 名参与者的 10 年肺癌特异性生存率为 81%（95%CI：79，84），20 年肺癌特异性生存率为 81%（95%CI：78，83），而 181 名病理 T1aN0M0 肺癌患者的 20 年肺癌特异性生存率为 95%（95%CI：91，98）。结论 正如扩大后的 I-ELCAP 队列的 20 年肺癌特异性生存率更新所显示的那样，2006 年报告的 I-ELCAP 参与者年度低剂量 CT 筛查和首次原发性肺癌诊断的 80%的 10 年肺癌特异性生存率持续存在。
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