ABSTRACT
Objective To clarify the significance of chest radiotherapy in the treatment of oligometastatic stage Ⅳ non-small cell lung cancer ( NSCLC ) and to explore the optimal time of interventional therapy during chest radiotherapy. Methods A total of 192 patients with oligometastatic stage Ⅳ NSCLC admitted to Shanxi Provincial Cancer Hospital from 2008 to 2014 were randomly and evenly divided into the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups. Survival analysis was performed with Kanplan-Meier method. Results The median survival of 192 patients with oligometastatic stage Ⅳ NSCLC was 14. 50 months, and the 1-,2-and 3-year survival rates were 57. 4％,24. 0％ and 10. 7％, respectively. The median survivalin the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+late intervention groups was 10,21,18 and 13 months, respectively. The 1-year survival rates were 34％, 73％,71％ and 51％,10％,40％,32％ and 13％ for the 2-year survival rates, and 0％,24％,16％ and 3％for the 3-year survival rates ( P=0. 000) . The median survival of patients with radiotherapy dose ≥ 60 Gy and< 60 Gy was 21 and 13 months, 76％ and 53％ for the 1-year survival rates, 34％ and 21％ for the 2-year survival rates, and 17％ and 10％ for the 3-year survival rates ( P=0. 002 ) . Conclusion Early interventional therapy and high-dose radiotherapy can improve the local control rate and prolong the survival time of patients with oligometastatic stage Ⅳ NSCLC.
ABSTRACT
Objective To investigate the factors associated with postoperative metastasis, recurrence, and survival in patients with stage ⅢA ( N2 ) non?small cell lung cancer ( NSCLC ) , and to provide an objective basis for postoperative radiotherapy in patients. Methods Clinical data were collected from 199 patients who underwent complete resection and were diagnosed with stage ⅢA ( N2 ) NSCLC after surgery in our hospital from 2009 to 2013. The Cox regression model was used for the multivariate analyses of metastasis and recurrence. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. Results In the 199 patients, 173 had complete follow?up data. The 1?and 2?year metastasis, recurrence, and survival rates were 38?7%/52?6%, 27?8%/39?1%, and 92?5%/51?4%, respectively. The multivariate analysis showed that pathological type and two positive indices among preoperative CEA/CY211/SCC were two risk factors for metastasis ( P=0?013,0?014) . Positive lymph node number, metastatic lymph node number, lymph node metastasis rate, and two positive indices among preoperative CEA/CY211/SCC were risk factors for recurrence ( P=0?046,0?004,0?028,0?001) . All the above indices were risk factors for low survival rates ( P= 0?013 , 0?011 , 0?002,0?026 ) . Conclusions Patients with stage ⅢA ( N2 ) NSCLC who have positive lymph nodes, lymph node metastases, and two positive indices among preoperative CEA/CY211/SCC may benefit from postoperative radiotherapy.