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Chinese Journal of Radiation Oncology  2022, Vol. 31 Issue (6): 519-524    DOI: 10.3760/cma.j.cn113030-20211008-00387
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Analysis of recurrence patterns of early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
Zheng Xiaoli, Ye Ke, Sun Yanan, Fan Chengcheng, Yang Yang, Wang Xiaohui, Liu Yang, Cheng Chen, Ge Hong
Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital, Zheng Zhou 450008, China
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Abstract  Objective To analyze the failure patterns and influencing factors of stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (ES-NSCLC). Methods 113 cases of ES-NSCLC treated with SABR from 2012 to 2020 in our hospital were retrospectively analyzed. The failure patterns, recurrence time, recurrence site and influencing factors were analyzed. Kaplan-Meier method was used to calculate the local recurrence rate, regional lymph node recurrence rate and distant metastasis rate. Univariate analysis was performed by Log-rank test, and multivariate analysis was performed by Cox model. Results The median follow-up time was 58 months (range:6-108 months), and a total of 45 patients (39.8%) recurred. The median recurrence time was 36 months. Distant metastasis (DM) occurred in 31 patients (27.4%) and DM alone in 24 patients (21.2%). Local recurrence (LR) was developed in 12 patients (10.6%) and LR alone in 7(6.2%). Regional lymph node recurrence (RR) occurred in 11 patients (9.7%) and RR alone in 6 patients (5.3%). LR combined with RR was observed in 1 case (0.9%), LR combined with DM in 3(2.7%), LR combined with RR and DM in 1(0.9%), and RR combined with DM in 3(2.7%). The 1-, 2-, 3-, 4-and 5-year recurrence rates were 5.4%, 16.6%, 27.5%, 44% and 51.2%, respectively. Univariate and multivariate analyses suggested that EGFR mutation was an influencing factor of high recurrence rate. Conclusion ES-NSCLC patients treated with SABR alone have a high recurrence rate, and DM is the most common mode of failure. Follow-up consolidation therapy is recommended, especially for EGFR mutation-positive NSCLC patients.
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Articles by authors
Zheng Xiaoli
Ye Ke
Sun Yanan
Fan Chengcheng
Yang Yang
Wang Xiaohui
Liu Yang
Cheng Chen
Ge Hong
Key wordsStereotactic ablative radiotherapy      Carcinoma, non-small-cell lung, early stage      Recurrence pattern      Risk factor     
Received: 08 October 2021     
Fund:Surface Project of National Natural Science Foundation of China (81773230)
Corresponding Authors: Ge Hong, Email:gehong666@126.com   
Cite this article:   
Zheng Xiaoli,Ye Ke,Sun Yanan et al. Analysis of recurrence patterns of early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(6): 519-524.
Zheng Xiaoli,Ye Ke,Sun Yanan et al. Analysis of recurrence patterns of early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(6): 519-524.
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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20211008-00387     OR     http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I6/519
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