局部综合治疗对非小细胞肺癌合并孤立性骨少转移治疗结果的影响

IF 3.4 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-05-14 DOI:10.1016/j.jbo.2025.100688

Jia-nan Jin , Zheng-bo Song , Wen-xian Wang , Yi Li , Shi-yan Wu

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引用次数: 0

摘要

近年来，非小细胞肺癌（NSCLC）的低转移状态由于其对长期生存的潜在意义而被广泛研究。骨是少转移性非小细胞肺癌最常见的受累器官之一。局部综合治疗（CLT）对孤立性骨骼少转移NSCLC的价值仍有待确定。方法回顾性收集2008年8月至2022年3月间非小细胞肺癌单发骨少转移病例资料。采用Kaplan-Meier和Cox回归分析评估临床结果。结果67例患者纳入最终分析，其中23例（34.3%）接受了CLT治疗。非CLT组的中位无进展生存期（PFS）和总生存期（OS）分别为9.9和27.1个月，CLT组的中位无进展生存期（PFS）和总生存期（OS）分别为18.8和46.0个月。在多变量分析中，CLT成为与PFS改善相关的独立预后因素（P = 0.031），但与OS无显著相关性（P = 0.403）。在接受EGFR-TKIs治疗的23例患者中，CLT组的中位PFS为46.8个月，中位OS未达到，而非CLT组的中位PFS为15.7个月，中位OS为30.7个月。与单药治疗相比，CLT联合EGFR-TKI显著改善了PFS (P = 0.023)，但OS无显著差异（P = 0.095）。结论：在非小细胞肺癌伴孤立性骨骼少转移的患者中，CLT的实施对PFS有积极影响。与单独使用EGFR-TKI相比，EGFR-TKI联合CLT与延长PFS相关，尽管需要进一步验证以确认其对长期生存的影响。

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The impact of comprehensive local therapy on treatment outcomes of non-small cell lung cancer with solitary skeletal oligometastasis

Background

The oligometastatic status of non-small lung cancer (NSCLC) has been extensively studied over the years owing to its potential significance in long-term survival. Bone is one of the most commonly affected organs in oligometastatic NSCLC. The value of comprehensive local therapy (CLT) for NSCLC with solitary skeletal oligometastasis remains to be established.

Methods

Data on NSCLC cases with solitary skeletal oligometastasis were collected retrospectively between August 2008 and March 2022. Kaplan–Meier and Cox regression analyses were performed to assess clinical outcomes.

Results

Sixty-seven patients were included in the final analysis, 23 (34.3 %) of whom received CLT. Median progression-free survival (PFS) and overall survival (OS) were 9.9 and 27.1 months for the non-CLT cohort and 18.8 and 46.0 months for the CLT cohort, respectively. In multivariate analysis, CLT emerged as an independent prognostic factor associated with improved PFS (P = 0.031), but had no significant correlation with OS (P = 0.403). Among 23 patients treated with EGFR-TKIs, the CLT group had a median PFS of 46.8 months and a median OS that was not reached, while the non-CLT group had a median PFS of 15.7 months and a median OS of 30.7 months. CLT plus EGFR-TKI significantly improved PFS versus monotherapy (P = 0.023), though OS did not differ significantly (P = 0.095).

Conclusions

In NSCLC patients with solitary skeletal oligometastasis, implementation of CLT appeared to positively influence PFS. The combination of EGFR-TKI and CLT was associated with prolonged PFS compared to EGFR-TKI alone, though further validation is needed to confirm its impact on long-term survival.

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.