Analysis of local recurrence pattern for limited stage small cell lung cancer after IMRT plus chemotherapy

中华放射肿瘤学杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2020.03.004

W. Yan, Xuan Liu, Zongmei Zhou, Yuxia Wang, Z. Xiao, Q. Feng, Dong-fu Chen, L. Ji-ma, Jun Liang, L. Deng, Tao Zhang, Wenqing Wang, N. Bi, Xin Wang, Xiaozhen Wang, Z. Hui, Luhua Wang

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Abstract

Objective To investigate localized regional recurrence after chemotherapy and chest radiotherapy in limited stage small cell lung cancer (LS-SCLC), and explore the relationship between recurrence location and radiotherapy and chemotherapy and its influencing factors. Methods From 2006 to 2014, pathological LS-SCLC treated in CAMS, 125 patients had local recurrence, Kaplan-Meier statistical method was used to analyze the survival rate and PFS of each recurrence site. Log-rank was used to compare the survival rate of each group. Univariate analysis includes Chi-squareand t-test for the factors for the recurrence site. Multivariate analysis using Logistic regression. Results The 1-, 2-and 5-year overall survival rates were 92.0%, 46.4% and 14.7%, respectively. The median progression time was 12.96 months, The median survival time after progression was 11.5 months, and the 1-, 2-, and 5-year overall survival rates were 45.0%, 23.0%, and 10.0%, respectively. The recurrence sites include intrapulmonary recurrence (67 patients), regional lymph nodes (21 patients), simultaneous intrapulmonary and regional lymph nodes (28 patients), and contralateral or supraclavicular lymph nodes (9 patients). The median survival time were 23.96 months, 24.76 months, 23.23 months, and 18.66 months, and the 2-year survival rates were 49%, 52%, 46%, and11%, respectively (P=0.000, 0.004, 0.008). In 6 patients (4.0%), 5 patients were located in the supraclavicular region, and 1 patient (0.8%) in the field. Conclusions For LS-SCLC undergoing IMRT and chemotherapy, the local failure location is mainly located in the pulmonary, and further treatment of the split dose and targets requires further clinical exploration. Key words: Lung neoplasms/radiochemoradiation; Radiotherapy, intensity-modulated; Patterns of failure

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有限期小细胞肺癌放疗加化疗后局部复发模式分析

目的探讨癌症（LS-SCLC）化疗、放疗后局部复发的情况，探讨复发部位与放疗、化疗的关系及其影响因素。方法从2006年到2014年，病理性LS-SCLC在CAMS治疗，125例患者局部复发，采用Kaplan-Meier统计方法分析各复发部位的生存率和PFS。对数秩用于比较各组的生存率。单变量分析包括复发部位因素的卡方检验和t检验。使用Logistic回归的多变量分析。结果1、2、5年总生存率分别为92.0%、46.4%和14.7%。中位进展时间为12.96个月，中位进展后生存时间为11.5个月，1年、2年和5年总生存率分别为45.0%、23.0%和10.0%。复发部位包括肺内复发（67例）、区域淋巴结（21例）、同时存在肺内和区域淋巴结的（28例）以及对侧或锁骨上淋巴结（9例）。中位生存时间分别为23.96个月、24.76个月、23.23个月和18.66个月，2年生存率分别为49%、52%、46%和11%（P=0.000、0.004和0.008）。6名患者（4.0%）中，5名患者位于锁骨上区，1名患者（0.8%）位于现场。结论对于接受IMRT和化疗的LS-SCLC，局部失败位置主要位于肺部，进一步的分剂量和靶点治疗需要进一步的临床探索。关键词：肺肿瘤/放化疗；放射治疗，强度调节；故障模式

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来源期刊

中华放射肿瘤学杂志

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6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.