[an error occurred while processing this directive] | [an error occurred while processing this directive]
Result of stereotactic radiotherapy of oligometastasis non-small cell lung cancer
Hu Xiaolong,Li Hongqi,Xu Xiangsheng,Liu Hefei,Wu Weizhang,Xia Tingyi,Wang Yingjie
Department of Radiation Oncology,Air Force General Hospital,Beijing 100142,China (Hu XL now unit:Department of Radiation Oncology,Beijing Geriatric Hospital)
AbstractObjective To explore the curative effect and adverse reaction of applying stereotactic radiotherapy to primary lesion inside chest cavity of patients with oligometastasis non-small cell lung cancer and rendering radical radiotherapy to all metastases. Methods 43 patients with ≤5 metastases of non-small cell lung cancer received initial treatment during 2009-2015 in our department were analyzed;the stereotactic radiotherapy was adopted to implement radical radiotherapy on primary lesion and all metastases. The average and neutral position BED10 respectively were 101.416 Gy and 102.700 Gy,the number of neutral position chemotherapy period was 4.Kaplan-Meier method, survival analysis, Cox model, multi factor Prognosis analysis were used. Results By the end of January 10,2017 in 36 months’ neutral position follow-up visit,the total effective rate of lesion treatment of 86%;the survival rates after 1,2 and 3 years respectively were 74%, 70% and 51%. Neutral survival time was 48 months, and the progression-free time of neutral position was 15 months. Multi-factor analysis indicated that,ECOG<2 and ECOG≥2(P=0.000),BED10<100 Gy and BED10≥100 Gy (P=0.006) generated obvious influence on survival prognosis. About 90% of the patients only got 1-2 degree of adverse reaction without emerging treatment related death. Conclusions On the premise of systematic therapy of oligometastasis non-small cell lung cancer,combined with radical radiotherapy of primary lesion and metastasis can obviously improve patients’ overall survival and progression-free survival,the adverse reaction is durable.
Corresponding Authors:
Wang Yingjie,Email:wangyj9999@163.com
Cite this article:
Hu Xiaolong,Li Hongqi,Xu Xiangsheng et al. Result of stereotactic radiotherapy of oligometastasis non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(10): 1141-1146.
Hu Xiaolong,Li Hongqi,Xu Xiangsheng et al. Result of stereotactic radiotherapy of oligometastasis non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(10): 1141-1146.
[1] Jemal A,Bray F,Center,et al. Global cancer tatistics[J].CA Cancer J Clin,2011,61(2):69-90.DOI:10.3322/caac.20107. [2] Siegel R,Naishadham D.Jemal A.Cancer statistics,2012[J].CA Cancer J Glin,2012,62(1):10-29.DOI:10.3322/caac.20138. [3] Morgensztern D,Ng SH,Gao F,et al. Trends in stage distribution for patients with non-small cell lung cancer:a National Cancer Database survey[J].J Thorac Oncol,2010,5(1):29-33.DOI:10.1097/JTO.0b013e3181c5920. [4] Uoyang WW,Su SF,Ma Z,et al. Prognosis of non-small cell lung cancer patients with bone oligometastases treated concurrently with thoracic three-dimensional radiotherapy and chemotherapy[J].Radiat Oncol,2014,9(1):147.DOI:10.1186/1748-717X-9-147. [5] Ettinger DS,Akerley W,Bepler G,et al. Non-small cell lung cancer[J].J Natl Compr Canc Netw,2010,8(7):740-801.DOI:10.6004/jnccn.2010.0056. [6] National Cancer Institute. Surveillance,epidemiology and end results program:fast stats[DB/OL][2017-03-26].http://seer.cancer.gov/faststats/. [7] Mehta N,Mauer AM,Hellman S,et al. Analysisi of further disease progression in metastaic non-small cell lung cancer:implicationgs for locoregiongnal treatment[J].Int J Oncol,2004,25(6):1677-1683.DOI:10.3892/ijo.25.6.1677 [8] Hellman S,Weichselbaum PR.Oligometastases[J].J Clin Oncol,1995,13(1):8-10. [9] D’Addario G,Fruh M,Reck M,et al. Metastatic non-small-cell lung cancer:ESMO clinical practice guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2010,21(Suppl 5):v116-v119.DOI:10.1093/annonc/mdq189. [10] Lopez-Guerra JL,Gomez D,Zhuang Y,et al. Prognostic impact of radiation therapy to the primary tumor in patients with non-small cell lung cancer and oligometastasis at diagnosis[J].Int J Radiat Oncol Biol Phys,2012,84(1):e61-e67.DOI:10.1016/j.ijrobp.2012.02.054. [11] Salama JK,Chmura SJ,Mehta N,et al. An initial report of a radiation dose-escalation trial in patients with one to five sites of metastatic disease[J].Clin Cancer Res,2008,14(16):5255-5259.DOI:10.1158/1078-0432.CCR-08-0358. [12] Milano MT,Katz AW,Zhang H,et al. Oligometastases treated with stereotactic body radiotherapy:Long-term follow-up of prospective study[J].Int J Radiat Oncol Biol Phys,2012,83(3):878-886.DOI:10.1016/j.ijrobp.2011.08.036. [13] Postmus PE,Brambilla E,Chansky K,et al. The IASLC lung cancer staging project:proposals for revision of the M description in the forthcoming edition of the TNM classification of lung cancer[J]. J Thorac Oncol.2007 Aug;2(8):686-93. [14] Salama JK,Chmura SJ,Mehta N,et al. An initial report of a raciation dose-escalation trial in patients with one to five sites of metastatic disease[J].Clin Cancer Res.2008 Aug 15;14(16):5255-9. doi:10.1158/1078-0432. [15] Sheu T,Heymach JV,Swisher SG,et al.propensity score-matched analysis of comprehensive local therapy for oligometastastaic non-small cell lung cancer that did not progress after front-line chemotherapy[J].Int J Radiat Oncol Biol Phys,2014,90(4):850-857.DOI:10.1016/j.ijrobp.2014.07.012. [16] Parikh RB,Cronin AM,Kozono DE,et al. Definitive primary therapy in patients presenting with oligometastatic non-small cell lung cancer[J].Int J Radiat Oncol Biol Phys,2014,89(4):e880-e887.DOI:10.1016/j.ijrobp.2014.04.007. [17] Loriot Y,Sofia JC,Le Chevalier T.Expanding role of chemothrerapy in lung cancer[J].Am Oncol,2006,17(10):101-107. [18] Downey RJ,Ng KK,Kris MG,et al. A phase Ⅱ trial of chemotherapy and surgery for non-small cell lung cancer patients with a synchronous solitary metastasis[J].Lung Cancer,2002,38(1):193-197. [19] Pfannschmidt J,Dienemann H.Surgical treatment of oligometastatic non-small cell lung cancer[J].Lung Cancer,2010,69(2):251-258.DOI:10.1016/j.lungcan.2010.05.003. [20] Flannery TW,Suntharaligam M,Regine WF,et al.long-term surv Ⅳ al in patients with synchronous,solitary brain metastasis from non-small-cell lung cancer treated with radiosurgery[J].Int J Radiat Oncol Biol Phys,2008,72(1):19-23.DOI:10.1016/j.ijrobp.2007.12.031. [21] Collaud S,Stahel R,Inci I,et al. Survival of patients treated sugically for synchronous single-organ metastatic NSCLC and advanced pathologic TN stage[J].Lung Cancer,2012,78(3):234-238.DOI:10.1016/j.lungcan.2012.09.011. [22] Eberhardt WE,Mitchell A,Crowley J,et al. The LASLC lung cancer staging project:proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer[J].J Thorac Oncol,2015,10(11):1515-1522.DOI:10.1097/JTO.0000000000000673. [23] Thariat J,Marcy PY,lagrange JL.Trends in radiation therapy for the treatment of metastatic and oligometastatic disease in 2010[J].Bull Cancer,2010,97(12)1467-1476.DOI:10.1684/bdc.2010.1230. [24] Rusthoven KE,Kavanagh BD,Burri SH,et al. Multi-institutional phaseⅠ/Ⅱtrial of stereotactic body radiation therapy for lung metastases[J].J Clin Oncol,2009,27(10):1579-1584.DOI:10.1200/JCO.2008.19.6386. [25] De Rose F,Cozzi L,Navarria P,et al. Clinical outcome of stereotactic ablative body radiotherapy for lung metastaticlesions in non-small cell lung cancer oligometastatic patients[J].Clin Oncol (R Coll Radiol),2016,28(1):13-20.DOI:10.1016/j.clon. [26] Iwasaki A,Shirakusa T,Yoshinaga Y,et al. Evaluation of the treatment of non-small cell lung cancer with brain metastasis and the role of risk score as a survival predictor[J].Eur J Cardiothorac Surg,2004,26(3):488-493. [27] Hasselle MD,Haraf DJ,Rusthoven KE,et al. Hypofractionated image-guided radition therapy for patients with limited volume metastatic non-small cell lung cancer[J].J Thorc Oncol,2012,7(2):376-381.DOI:10.1097/JTO.0b013e31824166a5. [28] 吕家华,李涛,刘丽,等.Ⅳ期寡转移NSCLC同期放化疗后巩固化疗前瞻性Ⅱ期临床研究[J].中华放射肿瘤学杂志,2015,24(6):611-614.DOI:10.3760/cma.j.issn.1004-4221.2015.06.002. Lyu JH,Li T,Liu L,et al. A prospective phase Ⅱ study of consolidation chemotherapy after concuurent chenmoradiotherapy for oligometastasis stage ⅠV non-small lung cancer[J].Chin J Radiat Oncol,2015,24(6):611-614.DOI:10.3760/cma.j.issn.1004-4221.2015.06.002. [29] Gomez DR,Blumenschein GR Jr,Lee JJ,et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy:a multicentre,randomised,controlled,phase 2 study[J].Lancet Oncol,2016,17(12):1672-1682.DOI:10.1016/S1470-2045(16)30532-0.
2017, Vol. 26 
