Analysis of recurrence patterns of early-stage non-small cell lung cancer treated with stereotactic ablative radiotherapy
10.3760/cma.j.cn113030-20211008-00387
- VernacularTitle:早期非小细胞肺癌立体定向消融放射治疗失败模式分析
- Author:
Xiaoli ZHENG
1
;
Ke YE
;
Yanan SUN
;
Chengcheng FAN
;
Yang YANG
;
Xiaohui WANG
;
Yang LIU
;
Chen CHENG
;
Hong GE
Author Information
1. 郑州大学附属肿瘤医院&河南省肿瘤医院放疗科，郑州 450008
- Keywords:
Stereotactic ablative radiotherapy;
Carcinoma, non-small-cell lung, early stage;
Recurrence pattern;
Risk factor
- From:
Chinese Journal of Radiation Oncology
2022;31(6):519-524
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the failure patterns and influencing factors of stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer (ES-NSCLC).Methods:113 cases of ES-NSCLC treated with SABR from 2012 to 2020 in our hospital were retrospectively analyzed. The failure patterns, recurrence time, recurrence site and influencing factors were analyzed. Kaplan-Meier method was used to calculate the local recurrence rate, regional lymph node recurrence rate and distant metastasis rate. Univariate analysis was performed by Log-rank test, and multivariate analysis was performed by Cox model.Results:The median follow-up time was 58 months (range: 6-108 months), and a total of 45 patients (39.8%) recurred. The median recurrence time was 36 months. Distant metastasis (DM) occurred in 31 patients (27.4%) and DM alone in 24 patients (21.2%). Local recurrence (LR) was developed in 12 patients (10.6%) and LR alone in 7(6.2%). Regional lymph node recurrence (RR) occurred in 11 patients (9.7%) and RR alone in 6 patients (5.3%). LR combined with RR was observed in 1 case (0.9%), LR combined with DM in 3(2.7%), LR combined with RR and DM in 1(0.9%), and RR combined with DM in 3(2.7%). The 1-, 2-, 3-, 4-and 5-year recurrence rates were 5.4%, 16.6%, 27.5%, 44% and 51.2%, respectively. Univariate and multivariate analyses suggested that EGFR mutation was an influencing factor of high recurrence rate.Conclusion:ES-NSCLC patients treated with SABR alone have a high recurrence rate, and DM is the most common mode of failure. Follow-up consolidation therapy is recommended, especially for EGFR mutation-positive NSCLC patients.
