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Prognostic reanalysis of stage IV non-small cell lung cancer treated by chemotherapy with concurrent three-dimensional radiotherapy
Ouyang-Wei Wei, Lu Bing, Su Shengfa, Hu Yinxiang, Ma Zhu, Li Qingsong, Geng Yichao, Chen Xiaxia, Yang Wengang, Li Huiqin.
Department of Oncology, Affiliated Hospital of Guiyang Medical College,Teaching and Research Section of Oncology of Guiyang Medical College, Guizhou Province Cancer Hospital. Guiyang 550004, China
AbstractObjective To further analyze the prognostic factors in stage IV non-small cell lung cancer (NSCLC) treated by chemotherapy with concurrent three-dimensional radiotherapy. Methds We enrolled 201 patients with stage IV NSCLC in this study from January 2003 to July 2010 and analyzed overall survival (OS) in 159 patients (three-dimensional radiotherapy>36 Gy) and progression-free survival (PFS) in 120 patients. Platinum-based doublets chemotherapy was performed, and the median number of cycles was 4;the median dose to the planning target volume was 63 Gy. Survival rates were calculated by the Kaplan-Meier method and compared by the log-rank test. The time of multivariate prognostic analysis with the Cox model was increased from 3 years to 5 years. Results The 1-, 2-, 3-, and 5-year OS rates were 40.1%, 17.3%, 10.2%, and 5.1%, respectively, and the median survival time was 10 months. The short-term complete response, partial response, stable disease, and progressive disease rates were 7.5%, 66.0%, 19.5%, and 6.9%, respectively, and the median survival times were 19, 13, 8, and 6 months, respectively (P=0.000). The 1-, 2-, 3-, and 5-year PFS rates and median survival times of patients undergoing 4 to 5 cycles of chemotherapy with radiotherapy doses of ≥63 Gy and<63 Gy were 77.4% vs. 32.6%, 36.2% vs. 21.7%, 27.2% vs. 0%, 15.9% vs. 0%, and 20 vs. 9 months, respectively (P=0.002). According to multivariate analysis, 4 to 5 cycles of chemotherapy, stable or increased Karnofsky Performance Scale score after treatment, and gross tumor volume<175 cm3 were independent prognostic factors for a better OS (P=0.035, 0.000, and 0.008, respectively). Radiation dose to the primary tumor≥63 Gy resulted in a better PFS (P=0.051), which was of borderline significance. ConclusionsChemotherapy (4-5 cycles) with concurrent three-dimensional radiotherapy (≥63 Gy) may significantly prolong PFS and OS in patients with stage IV NSCLC.
Corresponding Authors:
Lu Bing, Email:lbgymaaaa@sohu.com
Cite this article:
Ouyang-Wei Wei,Lu Bing,Su Shengfa et al. Prognostic reanalysis of stage IV non-small cell lung cancer treated by chemotherapy with concurrent three-dimensional radiotherapy[J]. Chinese Journal of Radiation Oncology, 2014, 23(6): 485-488.
Ouyang-Wei Wei,Lu Bing,Su Shengfa et al. Prognostic reanalysis of stage IV non-small cell lung cancer treated by chemotherapy with concurrent three-dimensional radiotherapy[J]. Chinese Journal of Radiation Oncology, 2014, 23(6): 485-488.
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2014, Vol. 23 
