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原发肿瘤体积对IV期非小细胞肺癌生存影响——来自多中心Ⅱ期前瞻性临床研究结果再分析
罗兰, 欧阳伟炜, 苏胜发, 马筑, 李青松, 杨文刚, 付士美, 卢冰
贵州医科大学附属医院 贵州省肿瘤医院胸部肿瘤科,贵阳 550004
Influence of survival in primary tumor volume for stage IV non-small cell lung cancer on survival-re-analysis of phase II multicenter prospective clinical findings
Luo Lan,Ouyang Weiwei,Su Shengfa,Ma Zhu,Li Qingsong,Yang Wengang,Fu Shimei,Lu Bing
Department of Oncology,Guizhou Cancer Hospital,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China
Abstract：Objective To investigate the effect of primary tumor volume on the survival in the three-dimensional radiotherapy of primary tumors of stage Ⅳ non-small cell lung cancer (NSCLC). Methods Clinical data of 428 patients in a multicenter prospective clinical study from December 2002 to January 2017 were reanalyzed, and 423 of them were subject to survival analyses. Platinum-based doublet chemotherapy was adopted. The median number of chemotherapy cycle was 4, and the critical value of planning target volume (PTV) of primary tumors was 63 Gy. The critical value of gross tumor volume (GTV) of primary tumors was 150 cm3. Results Single factor Cox regression analysis demonstrated that female, KPS score, single organ metastasis,N0-N1 staging, adenocarcinoma, radiotherapy dose ≥63 Gy,4-6 cycles of chemotherapy, recent effectiveness, post-treatment progress in taking targeted drugs and GTV<150 cm3 were good prognostic factors for the patients with stage Ⅳ NSCLC (all P<0.05). According to the stratified analysis of different radiotherapy regimes, for the stage Ⅳ NSCLC patients with a GTV ≥150 cm3,the survival rate of the primary tumor radiotherapy dose ≥63 Gy on the basis of systemic chemotherapy was significantly better than that of the primary tumor radiotherapy dose <63 Gy (P<0.05). Conclusions Stage Ⅳ NSCLC patients with GTV≥150 cm3 in 4-6 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy and GTV<150 cm3 in 1-3 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy may prolong the overall survival of patients with stage Ⅳ NSCLC.
Luo Lan,Ouyang Weiwei,Su Shengfa et al. Influence of survival in primary tumor volume for stage IV non-small cell lung cancer on survival-re-analysis of phase II multicenter prospective clinical findings[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 660-664.
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2019, Vol. 28 
