Multicenter 5-year survival analysis of weekly Endostar combined with concurrent chemoradiotherapy for unresectable locally advanced non-small cell lung cancer
Ma Honglian1, Peng Fang2, Zhai Yirui3, Bao Yong2, Xu Yujin1, Zhao Lujun4, Li Dongming5, Hui Zhouguang6, Xu Liming4, Hu Xiao1, Wang Lyuhua3, Chen Ming1
1Department of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou 310022,China; 2Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; 3Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 4Department of Radiation Oncology, Cancer Hospital, Tianjin Medical University, Tianjin 300060, China; 5Department of Radiotherapy, Peking University Cancer Hospital, Beijing 100142, China; 6Department of Special Medical, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
Abstract：Objective To evaluate the 5-year survival outcome of patients with unresectable locally advanced non-small cell lung cancer (NSCLC) treated with Endostar in combination with platinum-based concurrent chemoradiotherapy. Methods From March 2009 to June 2015,115 patients with the unresectable locally advanced NSCLC from two prospective studies[Clinical trials 2009-2012(ClinicalTrials.gov NCT01894) and 2012-2015(ClinicalTrials.gov, NCT01733589)] were treated with Endostar in combination with platinum-based concurrent chemoradiotherapy. A total dose of 60-66 Gy was delivered in 30-33 fractions. Endostar was given 1 week prior to the beginning of radiotherapy, and repeated fortnightly during the concurrent chemoradiotherapy. After long-term follow up, survival outcome was evaluated in 104 patients treated with radiation dose of ≥60 Gy. Kaplan-Meier method was used for survival analysis. Univariate survival analysis was performed using the log-rank test. Results Of 104 eligible patients, 60.6% of them had squamous carcinoma and 65.4% were classified in stage ⅢB. All the patients received ≥2 cycles of Endostar and 93.3% of them received 4 cycles of Endostar. The median follow-up time was 68.3 months. The median overall survival (OS) and median progression-free survival (PFS) were 31.3 and 13.9 months, respectively. The 3-year and 5-year OS were 45.6% and 35.7%, respectively. The 3-year and 5-year PFS were 27.1% and 24.9%, respectively. Univariate analysis indicated that sex, ECOG, pathological type, clinical stage, radiotherapy technique, chemotherapy regimen, chemotherapy cycle and cycle of Endostar use were not associated with OS. Late radiation injury occurred in 14.4% of patients, and no grade 4-5 late injury was observed. Conclusion Patients with unresectable locally advanced NSCLC treated with Endostar fortnightly in combination with platinum-based concurrent chemoradiotherapy achieve better OS than historical data with tolerable toxicities.
Ma Honglian,Peng Fang,Zhai Yirui et al. Multicenter 5-year survival analysis of weekly Endostar combined with concurrent chemoradiotherapy for unresectable locally advanced non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(1): 23-28.
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