69例侵犯胸壁NSCLC失败模式及术后放疗价值初探

doi:10.3760/cma.j.cn113030-20200218-00059

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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.

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	Articles by authors
	Muyasha·Abulimiti
	Liang Jun

Key words： Invasion of the chest wall, lung cancer/surgery Invasion of the chest wall, lung cancer/postoperative radiotherapy Prognosis

Received: 18 February 2020

Corresponding Authors: Liang Jun,Email:liang23400@163.com

Cite this article:

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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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200218-00059 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I3/239

[1] Facciolo F,Cardillo G,Lopergolo M,et al.Chest wall invasion in non-small cell lung carcinoma:a rationale for en bloc resection[J].J Thorac Cardiovasc Surg,2001,121(4):649-656.DOI:10.1067/mtc.2001.112826.
[2] Caruana EJ,Solli P,Coonar AS.Hybrid video-assisted thoracoscopic surgery lobectomy and en-bloc chest wall resection for non-small cell lung cancer[J].J Thorac Dis,2016,8(9):E935-E937.DOI:10.21037/jtd.2016.08.24.
[3] Santos HTA,Lopes AJ,Higa C,et al.Lung cancer with chest wall invasion:retrospective analysis comparing en-bloc resection and′resection in bird cage′[J].J Cardiothorac Surg,2014,9(1):57.DOI:10.1186/1749-8090-9-57.
[4] Kelsey CR,Marks LB,Hollis D,et al.Local recurrence after surgery for early stage lung cancer:an 11-year experience with 975 patients[J].Cancer,2009,115(22):5218-5227.DOI:10.1002/cncr.24625.
[5] Matsuoka H,Nishio W,Okada M,et al.Resection of chest wall invasion in patients with non-small cell lung cancer[J].Eur J Cardiothorac Surg,2004,26(6):1200-1204.DOI:10.1016/j.ejcts.2004.07.038.
[6] Chapelier A,Fadel E,Macchiarini P,et al.Factors affecting long-term survival after en-bloc resection of lung cancer invading the chest wall[J].Eur J Cardiothorac Surg,2000,18(5):513-518.DOI:10.1016/S1010-7940(00)00537-6.
[7] Hanagiri T,Shinohara S,Takenaka M,et al.Clinical characteristics of resected T3 non-small cell lung cancer characterized by parietal pleural invasion or chest wall invasion[J].Indian J Surg,2014,76(5):354-358.DOI:10.1007/s12262-012-0709-z.
[8] Magdeleinat P,Alifano M,Benbrahem C,et al.Surgical treatment of lung cancer invading the chest wall:results and prognostic factors[J].Ann Thorac Surg,2001,71(4):1094-1099.DOI:10.1016/S0003-4975(00)02666-7.
[9] Tandberg DJ,Kelsey CR,D′Amico TA,et al.Patterns of failure after surgery for non–small-cell lung cancer invading the chest wall[J].Clin Lung Cancer,2017,18(4):e259-e265.DOI:10.1016/j.cllc.2016.11.008.
[10] Lee CY,Byun CS,Lee JG,et al.The prognostic factors of resected non-small cell lung cancer with chest wall invasion[J].World J Surg Oncol,2012,10(1):9.DOI:10.1186/1477-7819-10-9.
[11] Voltolini L,Rapicetta C,Luzzi L,et al.Lung cancer with chest wall involvement:predictive factors of long-term survival after surgical resection[J].Lung Cancer,2006,52(3):359-364.DOI:10.1016/j.lungcan.2006.01.010.
[12] Doddoli C,D′Journo B,Le Pimpec-Barthes F,et al.Lung cancer invading the chest wall:a plea for en-bloc resection but the need for new treatment strategies[J].Ann Thorac Surg,2005,80(6):2032-2040.DOI:10.1016/j.athoracsur.2005.03.088.
[13] Park JH,Shim YM,Baek HJ,et al.Postoperative adjuvant therapy for stage Ⅱ non–small-cell lung cancer[J].Ann Thorac Surg,1999,68(5):1821-1826.DOI:10.1016/S0003-4975(99)00715-8.
[14] Kawaguchi K,Yokoi K,Niwa H,et al.Trimodality therapy for lung cancer with chest wall invasion:initial results of a phase Ⅱ study[J].Ann Thorac Surg,2014,98(4):1184-1191.DOI:10.1016/j.athoracsur.2014.05.022.