Ⅳ期寡转移NSCLC放疗及最佳介入时机研究

doi:10.3760/cma.j.issn.1004-4221.2018.11.005

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Abstract Objective To clarify the significance of chest radiotherapy in the treatment of oligometastatic stage ⅠV non-small cell lung cancer (NSCLC) and to explore the optimal time of interventional therapy during chest radiotherapy. Methods A total of 192 patients with oligometastatic stage ⅠV NSCLC admitted to Shanxi Provincial Cancer Hospital from 2008 to 2014 were randomly and evenly divided into the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups. Survival analysis was performed with Kanplan-Meier method. Results The median survival of 192 patients with oligometastatic stage ⅠV NSCLC was 14.50 months, and the 1-,2-and 3-year survival rates were 57.4%,24.0% and 10.7%, respectively. The median survivalin the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups was 10,21,18 and 13 months, respectively. The 1-year survival rates were 34%,73%,71% and 51%,10%,40%,32% and 13% for the 2-year survival rates, and 0%,24%,16% and 3% for the 3-year survival rates (P=0.000).The median survival of patients with radiotherapy dose ≥ 60 Gy and< 60 Gy was 21 and 13 months, 76% and 53% for the 1-year survival rates, 34% and 21% for the 2-year survival rates, and 17% and 10% for the 3-year survival rates (P=0.002). Conclusion Early interventional therapy and high-dose radiotherapy can improve the local control rate and prolong the survival time of patients with oligometastatic stage ⅠV NSCLC.

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	Articles by authors
	Li Ruining
	Li Xiaomin
	Li Qi
	Ren Yaqiong
	Wu Yajuan
	Ren Yuejun

Key words： Lung neoplasm/radiotherapy Oligometastasis Intervention timing Prognosis

Received: 06 December 2017

Corresponding Authors: Li Xiaomin,Email:xmli11@126.com

Cite this article:

Li Ruining,Li Xiaomin,Li Qi et al. The clinical study of chest radiotherapy and optimal timing of intervention in oligometastatic stage Ⅳ NSCLC[J]. Chinese Journal of Radiation Oncology, 2018, 27(11): 975-979.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2018.11.005 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2018/V27/I11/975

[1] Chen VW,Bernardo A.Ruiz MD PhD,Msph M C H,et al. Analysis of stage and clinical/prognostic factors for lung cancer from SEER registries:AJCC staging and collaborative stage data collection system[J].Cancer,2014,120(S23):3781-3792.DOI:10.1002/cncr.29045.
[2] Luketich JD,Martini MN,Ginsberg RJ,et al. Successful treatment of solitary extracranial metastases from non-small cell lung cancer[J].Ann Thorac Surg,1995,60(6):1609-1611.DOI:10.1016/0003-4975(95)00760-1.
[3] Azzoli CG,Temin S,AliffT,et al2011 focused update of 2009 American society of clinical oneology clinical practice guideline update on chemotherapy for stage Ⅳ non-small cell lung cancer[J].Clin Oncol,2011,29(28):3825-3831.DOI:10.1200/JOP.2011.000374.
[4] Salama JK,Schild SE.Radiation therapy for oligometastasic non-small cell lung cancer[J].Cancer Metest Rev,2015,34(2):183-193.
[5] Shimada Y,Saji H,Kakihana M,et al. Survival outcomes for oligometastasis in resected non-small cell lung cancer[J].Asian Cardiovasc Thorac Ann,2015,23(8):937-944.DOI:10.1177/0218492315596463.
[6] Eberhardt WE,Mitchell A,Crowley J,et al. The IASLC lung cancer staging project:proposals for the Revision of the M descriptors in the forthcoming eight edition of the TNM classification of lung cancer[J].J Thorac Oncol,2015,10(11):1515-1522.DOI:10.1097/JTO.0000000000000673.
[7] Suzuki H,Yoshino I.Approach for oligometastasis in non-small cell lung cancer[J].General Thorac Cardiovasc Surg,2016,64(4):192-196.DOI:10.1007/s11748-016-0630-7.
[8] Griffioen GH,Toguri D,Dahele M,et al. Radical treatment of synchronous oligometastatic non-small cell lung carcinoma (NSCLC):patient outcomes and prognostic factors[J].Lung Cancer,2013,82(1):95-102.DOI:10.1016/j.lungcan.2013.07.023.
[9] Gray PJ,Mak RH,Yeap BY,et al. Aggressive therapy for patients with non-small cell lung carcinoma and synchronous brain-only oligometastatic disease is associated with long-term survival[J].Lung Cancer,2014,85(2):239-44.DOI:10.1016/j.lungcan.2014.06.001.
[10] Shimada Y,Saji H,Kakihana M,et al. Survival outcomes for oligometastasis in resected non-small cell lung cancer[J].Asian Cardiovasc Thorac Ann,2015,23(8):937-944.DOI:10.1177/0218492315596463.
[11] Palma DA.An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer[J].Clin Lung Cancer,2014,15(5):346-355.DOI:10.1016/j.cllc.2014.04.003.
[12] Bai H,Xu J,Yang H,et al. Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy[J].Oncotarg Ther,2016,9(1):4207-4213.DOI:10.2147/OTT.S106696.
[13] Cheruvu P,Su KM,Metcalfe J,et al. Comparison of outcomes in patients with stage Ⅲ versus limited stage Ⅳnon-small cell lung cancer[J].Radiat Oncol,2011,6(1):80.DOI:10.1186/1748-717X-6-80.
[14] Chang HJ,Hui-Ling K,Cheng-Yen L,et al. Hypofractionated radiotherapy for primary or secondary oligometastatic lung cancer using Tomotherapy[J].Radiat Oncol,2012,7(1):222.DOI:10.1186/1748-717X-7-222.
[15] Hasselle MD,Haraf DJ,Rusthoven KE,et al. Hypofractionated image-guided radiation therapy for patients with limited volume metastatic non-small cell lung cancer[J].J Lung Cancer,2012,7(2):376-381.DOI:10.1097/JTO.0b013e31824166a5.
[16] Lopez-Guerra JL,Gomez D,Zhuang Y,et al. Prognostic impact of radiation therapy to the primary tumor in patients with non-small cell lung cancer and oligometastasis at diagnosis[J].Int J Radiat Oncol Biol Phys,2012,84(1):e61-e67.DOI:10.1016/j.ijrobp.2012.02.054.
[17] De Ruysscher D,Wanders R,BA Van,et al. Radical treatment of non-small-cell lung cancer patients with synchronous oligometastases:long-term results of a prospective phase Ⅱ trial (Nct01282450)[J].J Lung Cancer,2012,7(10):1547.DOI:10.1097/JTO.0b013e318262caf6.
[18] 吕家华,李涛,刘丽,等.Ⅳ期寡转移NSCLC同期放化疗后巩固化疗前瞻性Ⅱ期临床研究[J].中华放射肿瘤学杂志,2015,24(6):611-614.doi:10.3760/cma.j.issn.1004-4221.2015.06.002.
Lyu JH,Li T,Liu L,et al. A prospective phase Ⅱ study of consolidation chemotherapy after concurrent chemoradiotherapy for oligometastatic stage ⅠV non-small cell lung cancer[J].Chin J Radiat Oncol,2015,24(6):611-614.DOI:10.3760/cma.j.issn.1004-4221.2015.06.002.