Cai Qian, Hu Kui, Dong Shuang, Li Xiaoyu, Hu Sheng, Deng Wenyou, Ou Wulin
Thoracic Inner Department I, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Transl Lung Cancer Res. 2024 Jul 30;13(7):1708-1717. doi: 10.21037/tlcr-24-465. Epub 2024 Jul 25.
Cavities have been reported in approximately 20% of lung cancer after anti-angiogenesis treatments. However, the effect of which on treatment outcomes remains unclear. This study sought to investigate the incidence and radiographic patterns of tumor cavitation in patients with non-small cell lung cancer (NSCLC) treated with apatinib, and its associations with patients' clinical characteristics and outcomes.
A total of 300 patients with NSCLC treated with apatinib were retrospectively identified. Baseline and follow-up chest computed tomography scans were reviewed to identify tumor cavitation, and the subsequent filling-in of the cavitation. A multivariate logistic regression analysis was conducted to identify the factors associated with tumor cavitation. Survival curves were constructed using the Kaplan-Meier method and compared using the log-rank test.
Of the 300 patients, 51 (17.0%) developed lung cavitation after initiating apatinib therapy. The results of the multivariate analysis showed that apatinib combination therapy ( apatinib monotherapy, odds ratio: 0.593, 95% confidence interval: 0.412-0.854, P=0.005) was significantly associated with tumor cavitation. Patients with tumor cavitation had significantly longer progression-free survival (PFS) than those without cavitation (8.2 5.2 months, P<0.01). Of the patients, 18 had cavity filling after progression, while 13 had persistent cavities after progression. The corresponding median PFS times were 11.9 and 3.2 months in patients with filled and persistent cavities after disease progression, respectively (P<0.001).
Tumor cavitation occurred in 17% of the NSCLC patients treated with apatinib and was associated with better PFS. Patients who had cavities filled after progression had a better prognosis than those with persistent cavities.
抗血管生成治疗后约20%的肺癌患者出现空洞。然而，其对治疗结果的影响仍不清楚。本研究旨在调查接受阿帕替尼治疗的非小细胞肺癌（NSCLC）患者肿瘤空洞形成的发生率、影像学特征，及其与患者临床特征和预后的相关性。
回顾性纳入300例接受阿帕替尼治疗的NSCLC患者。对基线和随访胸部计算机断层扫描进行评估，以确定肿瘤空洞形成情况及随后空洞的填充情况。进行多因素逻辑回归分析，以确定与肿瘤空洞形成相关的因素。采用Kaplan-Meier法构建生存曲线，并使用对数秩检验进行比较。
300例患者中，51例（17.0%）在开始阿帕替尼治疗后出现肺空洞。多因素分析结果显示，阿帕替尼联合治疗（与阿帕替尼单药治疗相比，比值比：0.593，95%置信区间：0.412-0.854，P=0.005）与肿瘤空洞形成显著相关。有肿瘤空洞的患者无进展生存期（PFS）显著长于无空洞的患者（8.2对5.2个月，P<0.01）。其中，18例患者在疾病进展后空洞填充，13例患者在疾病进展后空洞持续存在。疾病进展后空洞填充和持续存在的患者，其相应的中位PFS时间分别为11.9个月和3.2个月（P<0.001）。
接受阿帕替尼治疗的NSCLC患者中17%出现肿瘤空洞，且与较好的PFS相关。疾病进展后空洞填充的患者预后优于空洞持续存在的患者。
