Influence of survival in primary tumor volume for stage IV non-small cell lung cancer on survival-re-analysis of phase II multicenter prospective clinical findings
10.3760/cma.j.issn.1004-4221.2019.09.005
- VernacularTitle: 原发肿瘤体积对IV期非小细胞肺癌生存影响
- Author:
Lan LUO
1
;
Weiwei OUYANG
;
Shengfa SU
;
Zhu MA
;
Qingsong LI
;
Wengang YANG
;
Shimei FU
;
Bing LU
Author Information
1. Department of Oncology, Guizhou Cancer Hospital, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
- Publication Type:Journal Article
- Keywords:
Lung neoplasm/concurrent chemoradiotherapy;
Three-dimensional radiotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2019;28(9):660-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of primary tumor volume on the survival in the three-dimensional radiotherapy of primary tumors of stage Ⅳ non-small cell lung cancer (NSCLC).
Methods:Clinical data of 428 patients in a multicenter prospective clinical study from December 2002 to January 2017 were reanalyzed, and 423 of them were subject to survival analyses. Platinum-based doublet chemotherapy was adopted. The median number of chemotherapy cycle was 4, and the critical value of planning target volume (PTV) of primary tumors was 63 Gy. The critical value of gross tumor volume (GTV) of primary tumors was 150 cm3.
Results:Single factor Cox regression analysis demonstrated that female, KPS score, single organ metastasis, N0-N1 staging, adenocarcinoma, radiotherapy dose ≥63 Gy, 4-6 cycles of chemotherapy, recent effectiveness, post-treatment progress in taking targeted drugs and GTV<150 cm3 were good prognostic factors for the patients with stage Ⅳ NSCLC (all P<0.05). According to the stratified analysis of different radiotherapy regimes, for the stage Ⅳ NSCLC patients with a GTV ≥150 cm3, the survival rate of the primary tumor radiotherapy dose ≥63 Gy on the basis of systemic chemotherapy was significantly better than that of the primary tumor radiotherapy dose <63 Gy (P<0.05).
Conclusions:Stage Ⅳ NSCLC patients with GTV≥150 cm3 in 4-6 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy and GTV<150 cm3 in 1-3 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy may prolong the overall survival of patients with stage Ⅳ NSCLC.
