Analysis of failure patterns and survival after SBRT for 147 cases of T 1-2N 0M 0 stage non-small cell lung cancer
10.3760/cma.j.cn113030-20220920-00313
- VernacularTitle:147例T 1-2N 0M 0期非小细胞肺癌患者SBRT后失败模式及生存分析
- Author:
Lin WANG
1
;
Ruiqi WANG
;
Baiqiang DONG
;
Xiao HU
;
Honglian MA
;
Zhun WANG
;
Xiaojing LAI
;
Wei FENG
;
Xiao LIN
;
Youhua JIANG
;
Changchun WANG
;
Qiang ZHAO
;
Haitao JIANG
;
Pu LI
;
Xianghui DU
;
Ming CHEN
;
Qixun CHEN
;
Yujin XU
Author Information
1. 绍兴文理学院医学院，绍兴 312000
- Keywords:
Lung neoplasms;
Stereotactic body radiotherapy;
Failure pattern
- From:
Chinese Journal of Radiation Oncology
2023;32(8):683-688
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the failure patterns and survival after stereotactic body radiotherapy (SBRT) in patients with T 1-2N 0M 0 non-small cell lung carcinoma (NSCLC). Methods:Clinical data of early-stage NSCLC patients who received SBRT at Zhejiang Cancer Hospital from January 2012 to September 2018 were retrospectively analyzed. The primary observed endpoint was the pattern of disease progression, which was divided into intra-field recurrence, regional lymph node recurrence and distant metastasis. Overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan-Meier method. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox's model.Results:A total of 147 patients with 156 lesions were included. The median follow-up time was 44.0 months (16.5-95.5 months). A total of 57 patients (38.8%) progressed: 14 patients (24.5%) had recurrence with the 1-, 3-, and 5-year local recurrence rates of 2.0%, 10.9%, and 14.3%, respectively; 36 patients (63.2%) had Distant metastasis with the 1-, 3- and 5-year distant metastasis rates of 12.2%, 22.4% and 28.6%, respectively; and 7 patients (12.3%) had recurrence complicated with distant metastasis. The 3-, 5- and 7-year OS rates were 80.5%, 64.2% and 49.9% for all patients, respectively. The median OS was 78.4 months. The 3-, 5- and 7-year PFS rates were 64.8%,49.5% and 41.5%, with a median PFS of 57.9 months (95% CI: 42.3-73.5 months). Univariate and multivariate analyses showed that biologically equivalent dose and age were the factors affecting the efficacy of SBRT (both P<0.05). Conclusion:Distant metastasis is the main failure pattern in patients with T 1-2N 0M 0 NSCLC after SBRT. High-risk population should be selected for further systematic treatment to improve the efficacy.
