胸部放化疗后完全缓解的局限期小细胞肺癌脑转移风险

doi:10.3760/cma.j.cn113030-20220129-00048

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective Small cell lung cancer (SCLC) is a highly malignant tumor with a high risk of brain metastasis (BMs). The purpose of this study was to evaluate the clinical factors affecting the occurrence of BMs in patients with stage IIB-IIIB SCLC who achieved complete remission (CR) after thoracic radio-chemotherapy. Methods Clinical data of 191 patients with stage IIB-IIIB SCLC who achieved CR after thoracic radio-chemotherapy in Zhejiang Cancer Hospital from January 2009 to April 2016 were retrospectively analyzed. Common clinical factors related to the risk of BMs, including gender, age, thoracic radiotherapy dose, combined mode of radiotherapy and chemotherapy, pretreatment serum NSE and LDH, whether PCI was performed, TMN stage and PS score, were analyzed using log-rank method for univariate analysis, COX regression method for multivariate analysis and Kaplan-Meier method to plot the survival curve. Results Univariate analysis showed that pretreatment LDH level≥240IU, pretreatment NSE ≥17 ng/ml and no PCI were positively correlated with the risk of BMs (all P<0.05). Multivariate analysis showed that the risk of BMs was only positively correlated with pretreatment LDH≥240IU [HR: 1.90, 95%CI(1.07-3.37), P=0.029], and no PCI [HR:2.08, 95%CI(1.17-3.72), P=0.013]. Conclusions Pretreatment serum LDH levels provide important value for predicting the risk of BMs in patients with stage IIB-IIIB SCLC who achieve CR after thoracic radio-chemotherapy.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Shen Bin
	Liu Jianjiang
	Qiu Guoqin
	Ji Yongling
	Du Xianghui
	Yang Yang

Key words： Lactate dehydrogenase Small-cell lung carcinoma limited stage Brain metastasis Predictor

Received: 29 January 2022

Fund:; Fund programs: Natural Science Foundation of Zhejiang Province(LY20H160006); Zhejiang Medical and Health Science and Technology Project(2022KY109)

Corresponding Authors: Yang Yang, Email: yangyang@zjcc.org.cn

Cite this article:

Shen Bin,Liu Jianjiang,Qiu Guoqin et al. Risk analysis of brain metastases in limited-stage small cell lung cancer (LS-SCLC)achieving complete remission after thoracic radio-chemotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(7): 611-616.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20220129-00048 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2022/V31/I7/611

[1] 曹毛毛, 陈万青. GLOBOCAN 2020全球癌症统计数据解读[J]. 中国医学前沿杂志(电子版), 2021, 13(3): 63-69. DOI: 10.12037/YXQY.2021.03-10.
Cao MM, Chen WQ.Interpretation on the global cancer statistics of GLOBOCAN 2020[J]. Chin J Front Med Sci (Electronic Version),2021,13(3):63-69. DOI: 10.12037/YXQY.2021.03-10.
[2] van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer[J]. Lancet, 2011, 378(9804):1741-1755. DOI: 10.1016/S0140-6736(11)60165-7.
[3] Jett JR, Schild SE, Kesler KA, et al.Treatment of small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines[J]. Chest, 2013, 143(5 Suppl):e400S-e419S. DOI: 10.1378/chest.12-2363.
[4] Aupérin A, Arriagada R, Pignon JP, et al.Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. prophylactic cranial irradiation overview collaborative group[J]. N Engl J Med, 1999, 341(7):476-484. DOI: 10.1056/NEJM199908123410703.
[5] Simone CB, Bogart JA, Cabrera AR, et al.Radiation therapy for small cell lung cancer: an ASTRO clinical practice guideline[J]. Pract Radiat Oncol, 2020, 10(3):158-173. DOI: 10.1016/j.prro.2020.02.009.
[6] Eze C, Roengvoraphoj O, Manapov F.Prophylactic cranial irradiation in resected early-stage small cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2017, 98(3):612-614. DOI: 10.1016/j.ijrobp.2017.03.002.
[7] Yang Y, Zhang D, Zhou X, et al.Prophylactic cranial irradiation in resected small cell lung cancer: A systematic review with meta-analysis[J]. J Cancer, 2018, 9(2):433-439. DOI: 10.7150/jca.21465.
[8] Wen Q, Meng X, Xie P, et al.Evaluation of factors associated with platinum-sensitivity status and survival in limited-stage small cell lung cancer patients treated with chemoradiotherapy[J]. Oncotarget, 2017, 8(46):81405-81418. DOI: 10.18632/oncotarget.19073.
[9] Hermes A, Gatzemeier U, Waschki B, et al.Lactate dehydrogenase as prognostic factor in limited and extensive disease stage small cell lung cancer - a retrospective single institution analysis[J]. Respir Med, 2010, 104(12):1937-1942. DOI: 10.1016/j.rmed.2010.07.013.
[10] Tas F, Aydiner A, Demir C, et al.Serum lactate dehydrogenase levels at presentation predict outcome of patients with limited-stage small-cell lung cancer[J]. Am J Clin Oncol, 2001, 24(4):376-378. DOI: 10.1097/00000421-200108000- 00013.
[11] Fischer GM, Jalali A, Kircher DA, et al.Molecular profiling reveals unique immune and metabolic features of melanoma brain metastases[J]. Cancer Discov, 2019, 9(5):628-645. DOI: 10.1158/2159-8290.CD-18-1489.
[12] Yang J, Ren B, Yang G, et al.The enhancement of glycolysis regulates pancreatic cancer metastasis[J]. Cell Mol Life Sci, 2020, 77(2):305-321. DOI: 10.1007/s00018-019-03278-z.
[13] Yang Y, Su D, Zhao L, et al.Different effects of LDH-A inhibition by oxamate in non-small cell lung cancer cells[J]. Oncotarget, 2014, 5(23):11886-11896. DOI: 10.18632/oncotarget.2620.
[14] Yang Y, Chong Y, Chen M, et al.Targeting lactate dehydrogenase a improves radiotherapy efficacy in non-small cell lung cancer: from bedside to bench[J]. J Transl Med, 2021, 19(1):170. DOI: 10.1186/s12967-021-02825-2.
[15] Suzuki R, Wei X, Allen PK, et al.Hematologic variables associated with brain failure in patients with small-cell lung cancer[J]. Radiother Oncol, 2018, 128(3):505-512. DOI: 10.1016/j.radonc.2018.05.026.