Survival and prognostic factors of non-small cell lung cancer patients with postoperative locoregional recurrence treated with radical radiotherapy
- Author:
Ma LI
1
;
Qiu BO
;
Zhang JUN
;
Li QI-WEN
;
Wang BIN
;
Zhang XU-HUI
;
Qiang MENG-YUN
;
Chen ZHAO-LIN
;
Guo SU-PING
;
Liu HUI
Author Information
1. Department of Radiation Oncology
- Keywords:
Non-small cell lung cancer;
Locoregional recurrence;
Radical radiotherapy;
Biological effective dose;
Epidermal growth factor receptor
- From:Chinese Journal of Cancer
2017;36(11):657-664
- CountryChina
- Language:Chinese
-
Abstract:
Background: Locoregional recurrence remains the challenge for long-term survival of non-small cell lung cancer (NSCLC) patients after radical surgery, and curative-intent radiotherapy could be a treatment choice. This study aimed to assess the survival and prognostic factors of patients with postoperative locoregionally recurrent NSCLC treated with radical radiotherapy. Methods: We reviewed medical records of 74 NSCLC patients with postoperative locoregional recurrence who received radical radiotherapy between April 2012 and February 2016 at Sun Yat-sen University Cancer Center (Guang-zhou, China). The efficacy and safety of radical radiotherapy were analyzed. The probability of survival was estimated using the Kaplan–Meier method and compared using the log-rank test. The Cox proportional hazards model was used to identify prognostic factors. Results: Grade 3/4 adverse events included neutropenia (8 cases, 10.8％), esophagitis (7 cases, 9.5％), pneumonitis (1 case, 1.4％), and vomiting (1 case, 1.4％). The 2-year overall survival, progression-free survival, local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) rates of all patients were 84.2, 42.5, 70.0, and 50.9％, respectively. Univariate and multivariate analyses showed that a higher biological effective dose (BED) of radiation was associated with longer LRFS [hazard ratios (HR)= 0.317, 95％ confidence interval (CI)= 0.112–0.899,P= 0.016] and that wild-type epidermal growth factor receptor (EGFR) was associated with longer DMFS compared withEGFR muta-tion (HR= 0.383, 95％ CI= 0.171–0.855,P= 0.019). Conclusions: Radical radiotherapy is effective and well-tolerated in NSCLC patients with postoperative locoregional recurrence. High BED is a predictor for long LRFS, and the presence of wild-typeEGFR is a predictor for long DMFS.
