Prognostic Impact of Tumor Solid Components in Stereotactic Body Radiotherapy for Clinical Stage Tis-1N0M0 Lung Cancer.

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2025-06-01 DOI:10.1111/1759-7714.70110

Junki Fukuda, Hiroshi Doi, Atsushi Kono, Takaya Inagaki, Naoko Ishida Hamazawa, Saori Tatsuno Imamura, Takuya Uehara, Masahiro Inada, Kiyoshi Nakamatsu, Makoto Hosono, Kazunari Ishii, Yukinori Matsuo

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Abstract

Purpose: This study aimed to assess the potential of prognostic factors including consolidation tumor ratio (CTR) on treatment outcomes in patients with clinical stage 0-IA non-small cell lung cancer (NSCLC) undergoing stereotactic body radiotherapy (SBRT).

Methods: The analysis included data of 63 patients with 67 lesions of clinical stage 0-IA NSCLC treated with SBRT. According to the Union for International Cancer Control 8th edition, the following tumor stages were observed: Tis, 3; T1mi, 2; T1a, 11; T1b, 29; and T1c, 22. The prescribed dose was 48 (range, 42-52) Gy in four fractions.

Results: The median follow-up was 29.3 (range: 2.4-120.5) months. The five-year local control (LC), overall survival, and progression-free survival (PFS) rates were 89.4%, 60.3%, and 40.5%, respectively. Squamous cell carcinoma (Sq) and D_max < 125 Gy_BED10 for planning target volume (PTV) were associated with a worse LC (p = 0.001 and 0.017, respectively). Patients with Sq, T1b-c, CTR > 0.25, PTV ≥ 30 cm³ tumors were associated with worse PFS than those with non-Sq, ≤ cT1a, CTR ≤ 0.25, PTV < 30 cm³ tumors (p = 0.049, 0.004, 0.038, and 0.004, respectively). No recurrences, metastases, or deaths were found in patients with CTR ≤ 0.25 (n = 5).

Conclusion: In patients with stage 0-IA lung cancer treated with SBRT, tumors classified as ≤ T1a showed a better PFS than T1b-c. NSCLC with a low CTR of ≤ 0.25 seemed to have a low risk of recurrence after SBRT.

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立体定向放射治疗临床Tis-1N0M0期肺癌肿瘤实体成分对预后的影响。

目的：本研究旨在评估临床0-IA期非小细胞肺癌（NSCLC）接受立体定向放射治疗（SBRT）的预后因素，包括实变肿瘤比（CTR）对治疗结果的影响。方法：采用SBRT治疗的63例0-IA期非小细胞肺癌患者67个病灶。根据国际癌症控制联盟第8版，观察到以下肿瘤分期：第3期；T1mi 2;T1a, 11;T1b 29;T1c为22。处方剂量为48 Gy（范围42-52），分四次服用。结果：中位随访时间为29.3个月（范围：2.4-120.5个月）。5年局部控制（LC）、总生存率和无进展生存率（PFS）分别为89.4%、60.3%和40.5%。鳞状细胞癌（Sq）和Dmax BED10计划靶体积（PTV）与较差的LC相关（p分别= 0.001和0.017）。Sq、T1b-c、CTR≤0.25、PTV≥30 cm3肿瘤患者的PFS较非Sq、≤cT1a、CTR≤0.25、PTV 3肿瘤患者差（p分别为0.049、0.004、0.038、0.004）。CTR≤0.25的患者无复发、转移或死亡（n = 5）。结论：在接受SBRT治疗的0-IA期肺癌患者中，≤T1a的肿瘤的PFS优于T1b-c。低CTR≤0.25的NSCLC在SBRT后复发的风险似乎较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.