Chaonan Zhang , Wenqing Wang , Nan Bi, Jianyang Wang, Wenyang Liu, Tao Zhang, Xin Wang, Zefen Xiao, Jima Lv, Qinfu Feng, Lei Deng, Zongmei Zhou
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引用次数: 0
Abstract
Background and purpose
To evaluate the safety and efficacy of consolidative thoracic radiotherapy (cTRT) for extensive-stage small cell lung cancer (ES-SCLC) patients in the era of first-line chemoimmunotherapy.
Materials and methods
We retrospectively analyzed patients with ES-SCLC who accepted first-line platinum-based chemotherapy plus immunotherapy in our hospital from January 2018 to December 2021. CTRT was recommended for patients who achieved complete response (CR)/ partial response (PR) / stable disease (SD) after first-line systemic therapy. Patients were divided into cTRT and non-cTRT groups based on their receipt of cTRT. Categorical variables were compared using the Chi-squared test or Fisher’s exact test. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method, with comparisons by the log-rank test. Univariate and multivariate analyses were employed to identify prognostic factors for OS using the Cox proportional hazards model. Cumulative incidence of local regional progression (LRP) was calculated using the Fine-Gray competing risks regression model.
Results
We finally enrolled 100 patients in our cohort, comprising 48 patients who received cTRT and 52 who did not. The cTRT group exhibited significantly younger age distribution (72.9 % <65 years vs. 50 % in non-cTRT, p = 0.019), limited metastatic sites (≤1 metastatic site: 66.7 % vs. 32.7 %, p < 0.001), and fewer liver metastases (12.5 % vs. 32.7 %, p = 0.017), alongside higher PCI uptake rates (27.1 % vs 0 %, p = 0.001). The cTRT group had significantly longer median OS (26 vs. 17 months, p = 0.006) and PFS (10 vs. 6 months, p = 0.005) compared with the non-cTRT group. Multivariate analysis identified cTRT as the only prognostic factor correlated with improved OS (HR = 0.48, p = 0.04). The LRP at 1 year were 55.4 % and 22.3 % in the non-cTRT and cTRT group, respectively (p < 0.001). 3 (6.3 %) patients had grade 3 radiation esophagitis and 5 (10.4 %) patients developed grade 1–2 radiation pneumonitis in the cTRT group.
Conclusion
The administration of cTRT is safe and holds potential benefits for ES-SCLC patients responding to first-line chemoimmunotherapy.
期刊介绍:
Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.