Clinical outcome of radiotherapy for primary tumors in stage Ⅳ non-small cell lung cancer complicated with malignant pleural effusion
10.3760/cma.j.cn113030-20190623-00239
- VernacularTitle:伴恶性胸腔积液Ⅳ期NSCLC原发肿瘤三维放疗的临床分析
- Author:
Tianyu WEI
1
;
Zhu MA
;
Xiaxia CHEN
;
Xiaoyang LI
;
Weiwei OUYANG
;
Shengfa SU
;
Qingsong LI
;
Yichao GENG
;
Wengang YANG
;
Yinxiang HU
;
Huiqin LI
;
Bing LU
Author Information
1. 贵州医科大学附属医院肿瘤科/贵州医科大学肿瘤学教研室/贵州省肿瘤医院肿瘤科，贵阳 550004
- From:
Chinese Journal of Radiation Oncology
2020;29(7):523-528
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the clinical efficacy and safety of three-dimensional radiotherapy for the primary tumors in patients with stage Ⅳ non-small cell lung cancer complicated with malignant pleural effusion (MPE-NSCLC).Methods:A total of 198 patients who were initially pathologically diagnosed with MPE-NSCLC from January 2007 to April 2018 were enrolled and divided into the untreated group ( n=45), drug group ( n=57) and radiotherapy group ( n=96), respectively. The short-term efficacy, overall survival (OS) and adverse events in the drug and radiotherapy groups were analyzed. The OS rate was analyzed by Kaplan-Meier method and log-rank test. Clinical prognosis was evaluated by multivariate Cox′s regression model. Results:In the radiotherapy group, the objective response rate and non-response rate was 54% and 46%, significantly better than 25% and 75% in the drug group ( P=0.007). In the radiotherapy group, the 1-, 2-, 3-, 5-year OS and median survival was 47%, 18%, 6%, 1% and 12 months, remarkably higher than 15%, 3%, 2%, 0% and 5 months in the drug group, respectively (all P<0.001). Multivariate Cox′s regression analysis showed that radiotherapy for the primary tumors was an independent prognostic factor to prolong the OS ( P<0.001). Radiotherapy at a dose of ≥63 Gy and 4-6 cycles of chemotherapy tended to prolong the OS ( P=0.063 and 0.071). The OS of patients with EGFR mutation receiving radiotherapy combined with molecular target therapy was significantly better than that of those with unknown EGFR status treated with radiotherapy and chemotherapy ( P=0.007). Addition of radiotherapy for the primary tumors did not significantly increase the incidence of adverse events ( P>0.05). Conclusion:Addition of three-dimensional radiotherapy for the primary tumors in MPE-NSCLC patients may prolong the OS and yield tolerable adverse events.
