Comparison of efficacy between sequential and concurrent chemoradiotherapy in treatment of advanced lung cancer and analysis of prognostic factors
- VernacularTitle:序贯放化疗与同步放化疗对晚期肺癌的疗效比较及预后因素分析
- Author:
Ying ZHANG
1
;
Xu HE
;
Tingli YIN
Author Information
- Keywords: advanced lung cancer; sequential chemoradiotherapy; concurrent chemoradio-therapy; epidermal growth factor receptor; Karnofsky Performance Status; brain metastases; progres-sion-free survival; disease control rate
- From: Journal of Clinical Medicine in Practice 2025;29(10):63-67,72
- CountryChina
- Language:Chinese
- Abstract: Objective To compare the efficacy of sequential chemoradiotherapy and concurrent chemoradiotherapy in treatment of advanced lung cancer and analyze influencing factors of prognosis.Methods Ninety-six patients with advanced lung cancer were selected as study subjects and random-ly divided into control group and observation group,with 48 patients in each group.The control group received sequential chemoradiotherapy,while the observation group received concurrent chemoradio-therapy.The levels of epidermal growth factor receptor(EGFR)and Karnofsky Performance Status(KPS)were compared between the two groups before and after treatment.Additionally,the short-term efficacy,progression-free survival(PFS),overall survival(OS),and 1-year survival rate were compared between the two groups.Based on prognostic survival,the patients were divided into surviv-al group(n=64)and death group(n=32).The Cox regression model was used to analyze the prog-nostic factors in patients with advanced lung cancer,and a receiver operating characteristic(ROC)curve was plotted to evaluate the predictive efficacy of combined indicators.Results The objective re-sponse rate and disease control rate in the observation group were 60.42％and 87.50％,respectively,which were significantly higher than 35.42％and 60.42％in the control group(P＜0.05).After treatment,the EGFR level in the observation groupwas lower than that in the control group,while the KPS was higher(P＜0.05).The PFS and OS in the observation group were longer than those in the control group,and the 1-year survival rate was higher(P＜0.05).Significant differences were observed between the survival and death groups in terms of concurrent brain metastases,pre-treat-ment EGFR level,pre-treatment KPS,and treatment modality(P＜0.05).Multivariate Cox regres-sion analysis revealed that concurrent brain metastases,pre-treatment EGFR level,and treatment-modality were independent prognostic factors for patients with advanced lung cancer(P＜0.05).The ROC curve analysis showed that the area under the curve for the combination of concurrent brain metastases,pre-treatment EGFR level,and treatment modality in predicting the prognosis of patients with advanced lung cancer was 0.804,with a sensitivity of 0.688 and a specificity of 0.844.Conclusion Compared with sequential chemoradiotherapy,concurrent chemoradiotherapy is more effective in treatment of advanced lung cancer,thereby reducing EGFR levels,prolonging PFS and OS,and improving KPS and 1-year survival rate.Concurrent brain metastases,pre-treatment EGFR level,and treatment modality are independent prognostic factors,and their combination has a good predictive efficacy for prognosis.
