Implications of different metastatic sites for thoracic radiation in extensive-stage small cell lung cancer
10.3760/cma.j.cn113030-20211019-00418
- VernacularTitle:转移部位不同对广泛期小细胞肺癌胸部放疗价值的影响
- Author:
Huijun JIA
1
;
Jintao MA
;
Chunliu MENG
;
Hao YU
;
Jing LUO
;
Liming XU
;
Ningbo LIU
;
Ping WANG
;
Lujun ZHAO
Author Information
1. 天津医科大学肿瘤医院放疗科 国家肿瘤临床医学研究中心 天津市"肿瘤防治"重点实验室 天津市恶性肿瘤临床医学研究中心，天津 300060
- Keywords:
Carcinoma, small cell lung/radiotherapy;
Distant metastasis;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2022;31(4):334-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of thoracic radiotherapy in the treatment of patients with extensive-stage small cell lung cancer (ES-SCLC) with different metastatic sites.Methods:A retrospective analysis was performed among 830 ES-SCLC patients who were admitted to our hospital from 2010 to 2019. They all received the first-line chemotherapy and had no progression after chemotherapy. 341 patients of them received thoracic radiotherapy after chemotherapy. The main endpoint was overall survival. The Chi-square test was used to compare the categorical data including gender and age, etc. Univariate survival analysis was estimated by Kaplan-Meier method and the log-rank test was used to compare the survival curves between two groups. A multivariate prognostic analysis was made by the Cox proportional hazard model.Results:In all the patients, the overall survival (OS) was 12.4 months. The patients with thoracic radiotherapy had significantly higher OS than the patients without thoracic radiotherapy (15.2 months vs.10.8 months, P<0.001). Thoracic radiotherapy significantly improved the OS in patients without liver metastasis (16.0 months vs.11.4 months, P<0.001) in the oligometastatic patients. But for the oligometastatic patients with liver metastasis, the OS benefit was not significant (14.2 months vs. 10.6 months, P=0.072). For polymetastatic patients without liver metastasis, thoracic radiotherapy offered significant OS benefits (14.5 months vs.10.9 months, P<0.001), but for the polymetastatic patients with liver metastasis, the OS was not improved with thoracic radiotherapy (10.2 months vs.9.2 months, P=0.715). Conclusions:In ES-SCLC patients, thoracic radiotherapy provides significant OS benefits in patients with oligometastases ES-SCLC without liver metastasis and for the liver metastatic patients may also benefit from thoracic radiotherapy based on the effectiveness of chemotherapy. In patients with multiple metastases, thoracic radiotherapy only improves the OS in patients without liver metastasis, but does not improve the prognosis in patients with liver metastasis.
