当前位置： SCI文献检索 > BMC CANCER期刊下所有文献 > Might radiation therapy in addition to chemotherapy improve overall survival of patients with non-oligometastatic Stage IV non-small cell lung cancer?: Secondary analysis of two prospective studies.

Might radiation therapy in addition to chemotherapy improve overall survival of patients with non-oligometastatic Stage IV non-small cell lung cancer?: Secondary analysis of two prospective studies.

Abstract：

BACKGROUND:The role of radiation therapy in addition to chemotherapy has not been well established in non-oligometastatic Stage IV non-small cell lung cancer (NSCLC). We aimed to investigate overall survival (OS) of non-oligometastatic Stage IV NSCLC treated with chemotherapy with concurrent radiation to the primary tumor. METHODS:Eligible patients were screened from two prospective studies. Oligometastatic and non-oligometastatic NSCLC were defined as having < 5 and ≥5 metastatic lesions, respectively. Prognostic factors for OS were identified by using univariate and multivariate analysis. Landmark analysis and propensity-score matching (PSM) were each performed to further adjust for confounding. RESULTS:A total of 274 patients were identified as the study cohort: 183 had non-oligometastatic disease. For all 274 patients, those who received a radiation dose ≥63 Gy to the primary tumor and had oligometastatic disease had better OS (P < 0.001 and P = 0.017, respectively). When patients were subdivided into those with oligometastatic or non-oligometastatic disease, a radiation dose ≥ 63 Gy remained a significant prognostic factor for better OS. For non-oligometastatic patients, multivariate analysis showed that receiving ≥63 Gy radiation, having a GTV <146 cm3, having response to chemotherapy, and having stable or increased post-treatment KPS independently predicted better OS (P = 0.018, P = 0.014, P = 0.014, and P = 0.001). After PSM in non-oligometastatic patients, a higher radiation dose (≥63 Gy) remained to be correlated with better OS. By landmark analysis, aggressive radiation (≥63 Gy) remained to be correlated with better OS in Pre-PSM cohort (P = 0.005) and Post-PSM cohort (P = 0.004). CONCLUSIONS:Radiation dose, primary tumor volume, response to chemotherapy and KPS after treatment are associated with OS in patients with non-oligometastatic disease; on basis of effective system chemotherapy, aggressive thoracic radiotherapy may prolong OS.

journal_name

BMC Cancer

journal_title

BMC cancer

authors

Su S,Hu Y,Ouyang W,Ma Z,Li Q,Li H,Wang Y,Wang X,Li T,Li J,Chen M,Lu Y,Bai Y,He Z,Lu B

doi

10.1186/s12885-016-2952-3

subject

Has Abstract

pub_date

2016-11-21 00:00:00

pages

908

issue

issn

1471-2407

pii

10.1186/s12885-016-2952-3

journal_volume

pub_type

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Might radiation therapy in addition to chemotherapy improve overall survival of patients with non-oligometastatic Stage IV non-small cell lung cancer?: Secondary analysis of two prospective studies.