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Significance of three-dimensional radical radiotherapy dose determined by organ-lesion combination for primary tumor of oligometastatic stage IV NSCLC:a reanalysis of PPRA-RTOG 003
Wang Chunlan,Su Shengfa,Ouyang Weiwei,Ma Zhu,Li Qingsong,Wang Yu,Li Huiqin,Lu Bing
Guizhou Meidical University,Guiyang 550004,China (Wang CHL);Department of Thoracic Oncology,Affiliated Hospital of Guizhou Meidical University,Guizhou Province Tumor Hospital;Guiyang 550004,China (Su SHF,Ouyang WW,Ma ZH,Li QS,Wang Y,Li HQ,Lu B)
Objective To investigate the influence of three-dimensional radiotherapy dose determined by organ-lesion combination for the primary tumor of oligometastatic stage Ⅳ non-small cell lung cancer (NSCLC) and related factors on survival. Methods Oligometastasis was defined as the metastatic lesion in only one organ or 1 metastatic lesion in each of two organs. A total of 115 patients were enrolled,and the association of dose and related factors with overall survival was investigated. The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis,and the Cox regression model was used for multivariate analysis. Results Of all patients,the median survival time (MST) was 14 months,and the 1-,2-,and 3-year overall survival (OS) rates were 55.7%,18.3%,and 11.5%,respectively. All the patients,the patients benefiting from two-cycle chemotherapy,and the patients benefiting from chemoradiotherapy showed prolonged MST,and in patients receiving a primary tumor dose of ≥63 Gy or<63 Gy,the MST was 17 months and 13 months (P=0.046),17 months and 13 months (P=0.037),and 18 months and 14 months (P=0.022),respectively. Radiotherapy for metastatic lesion and effective treatment for primary tumor tended to prolong survival time,and the MST was 17 months and 13 months,respectively (P=0.055 and 0.065).The patients receiving 4-6 cycles of chemotherapy had an MST of 16 months and 13 months,respectively (P=0.165).The patients who received effective chemoradiotherapy,had a primary tumor volume of<120.1 cm3,and had improvement in Karnofsky Performance Scale (KPS) after treatment showed a prolonged MST compared with those who did not respond to chemoradiotherapy and had a large primary tumor volume and a reduction in KPS (15 months vs. 12 months,P=0.036;17 months vs. 11 months,P=0.002;14 months vs. 10 months,P=0.031).The multivariate analysis showed that primary tumor dose and volume (P=0.020 and 0.001) and the change in KPS after treatment (P=0.021) significantly affected survival. Conclusions The doses of chemotherapy and concurrent radical radiotherapy determined by organ-lesion combination for oligometastatic stage Ⅳ NSCLC can significantly prolong survival time,and primary tumor volume and KPS after treatment are the independent prognostic factors for survival.
Corresponding Authors:
Lu Bing,Email:lbgymaaaa@163.com
Cite this article:
Wang Chunlan,Su Shengfa,Ouyang Weiwei et al. Significance of three-dimensional radical radiotherapy dose determined by organ-lesion combination for primary tumor of oligometastatic stage IV NSCLC:a reanalysis of PPRA-RTOG 003[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 576-580.
Wang Chunlan,Su Shengfa,Ouyang Weiwei et al. Significance of three-dimensional radical radiotherapy dose determined by organ-lesion combination for primary tumor of oligometastatic stage IV NSCLC:a reanalysis of PPRA-RTOG 003[J]. Chinese Journal of Radiation Oncology, 2016, 25(6): 576-580.
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2016, Vol. 25 
