Preliminary study of values of failure mode and postoperative radiotherapy in 69 non-small cell lung cancer patients with chest wall invasion
Muyasha·Abulimiti1, Liang Jun2
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China; 2Department 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
Abstract：Objective: To preliminarily investigate the values of failure mode and postoperative radiotherapy in non-small cell lung cancer (NSCLC) patients with chest wall invasion. Methods A total of 69 T3 stage NSCLC patients who underwent thoracic surgery in our hospital from 2010 to 2018 and presented with postoperative pathological findings of chest wall invasion were recruited. The outcomes between the post-operative radiotherapy and non-radiotherapy groups were assessed by propsensity matching analysis. Kaplan-Meier survival analysis and Cox’s model prognostic factors analysis were performed. Results The median survival time of 69 patients was 25 months and the median progression-free survival was 8 months. Thirty-six cases were diagnosed with primary stage M0 including 28 cases (78%) of R0 resection and 33 cases (48%) were diagnosed with stage M1a and received non-R0 resection because of pleural metastases. In total, 53 cases (77%) suffered from disease progression, and 26 cases (38%) experienced local recurrence including 58% of mediastinal lymph node recurrence and 36% of chest wall tumor bed recurrence. Distant metastases were observed in 50 cases (73%) including 43% of pleural metastases. Univariate analysis showed that age, pathological staging, range of primary lesion invasion, postoperative radiotherapy and postoperative targeted therapy were significantly associated with overall survival (all P<0.05). The overall survival in the postoperative radiotherapy group was better than that in the non-radiotherapy group. No statistical difference was observed in the progression-free survival, local recurrence-free survival and distant metastasis-free survival between two groups (all P>0.05). Conclusions For NSCLC patients with chest wall invasion, distal metastasis failure is the main cause, while local failure mainly consists of mediastinal lymph node andchest wall recurrence. Postoperative radiotherapy may improve survival. Nevertheless, the combination and benefit degree of postoperative comprehensive treatment need to be further confirmed by prospective studies.
Muyasha·Abulimiti,Liang Jun. Preliminary study of values of failure mode and postoperative radiotherapy in 69 non-small cell lung cancer patients with chest wall invasion[J]. Chinese Journal of Radiation Oncology, 2021, 30(3): 239-243.
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2021, Vol. 30 
