A Comparison of Stereotactic Radiation Therapy in Elderly Patients with Central or Peripheral Stage I-II (T1-3 N0 M0) Non-Small Cell Lung Cancer.

IF 2.5 4区医学 Q3 ONCOLOGY Cancer Management and Research Pub Date : 2024-11-05 eCollection Date: 2024-01-01 DOI:10.2147/CMAR.S483569

Xiaoqin Ji, Xuebing Shi, Jun Hu, Wanrong Jiang, Bin Zhou, Houlong Zhou, Xi Yuan, Yikun Li, Hua Huang, Jiasheng Wang, Wei Ding, Yong Wang, Xiangdong Sun

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Abstract

Purpose: The objective of this study was to compare the clinical outcomes of stereotactic body radiation therapy (SBRT) in elderly patients aged 65 or older with clinical stage I-II non-small-cell lung cancer (NSCLC), specifically examining the differences between centrally located lung tumors and peripherally located lung tumors.

Methods: From April 2009 to January 2020, a total of 136 patients with 136 tumors (65 central, 71 peripheral; NSCLC) at an early stage (T1-3N0M0) were treated with SBRT at a single institution. Central/peripheral location was assessed retrospectively on planning CT scans. A propensity score matching analysis was utilized to compare the two groups. In addition, the prognosis and related toxicity were compared between the two study arms.

Results: A total of 33 central tumors and 33 peripheral tumors were matched and analyzed. The results showed no significant differences in overall survival (OS) and progression-free survival (PFS) between the two groups. The 2-year OS was 71.88% (95% CI, 57.87%-89.27%) in the central lung cancer group, while it was 93.94% (95% CI, 86.14%-100.00%) in the peripheral lung cancer group (P=0.462). The 2-year PFS was 43.75% in the central lung cancer group, while it was 78.79% in the peripheral lung cancer group (P=0.279). Further subgroup analysis indicated that the location of peripheral tumor have a positive impact on OS in patients with adenocarcinoma. The occurrence of local failure, regional failure, or distant failure was comparable between central and peripheral tumors. There was no statistically significant difference in toxicity between the central and the peripheral tumor groups.

Conclusion: The outcomes of SBRT for central tumors versus peripheral lung tumors in elderly patients with early-stage NSCLC were similar. SBRT demonstrated a similar level of safety in terms of toxicity for both central and peripheral lung tumors.

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比较立体定向放射疗法对中央型或周围型 I-II 期（T1-3 N0 M0）非小细胞肺癌老年患者的疗效。

目的：本研究旨在比较65岁或65岁以上临床分期为I-II期非小细胞肺癌（NSCLC）的老年患者接受立体定向体放射治疗（SBRT）的临床疗效，特别是研究位于中心位置的肺肿瘤与位于外周位置的肺肿瘤之间的差异：从 2009 年 4 月到 2020 年 1 月，一家医疗机构共对 136 例早期（T1-3N0M0）肿瘤患者（65 例中央型，71 例周围型；NSCLC）进行了 SBRT 治疗。中心/外周位置是通过计划 CT 扫描进行回顾性评估的。两组患者采用倾向得分匹配分析法进行比较。此外，还比较了两个研究组的预后和相关毒性：结果：共对33个中心肿瘤和33个周围肿瘤进行了匹配分析。结果显示，两组患者的总生存期（OS）和无进展生存期（PFS）无明显差异。中心肺癌组的 2 年 OS 为 71.88%（95% CI，57.87%-89.27%），而周围肺癌组为 93.94%（95% CI，86.14%-100.00%）（P=0.462）。中心肺癌组的 2 年生存率为 43.75%，而周围肺癌组为 78.79%（P=0.279）。进一步的亚组分析表明，周围肿瘤的位置对腺癌患者的 OS 有积极影响。中心肿瘤和周围肿瘤的局部失败、区域失败或远处失败的发生率相当。中心肿瘤组和周围肿瘤组的毒性差异无统计学意义：结论：SBRT治疗老年早期NSCLC患者肺中心肿瘤和周围肿瘤的效果相似。结论：SBRT 治疗老年早期 NSCLC 患者肺中心肿瘤和外周肿瘤的疗效相似，SBRT 治疗肺中心肿瘤和外周肿瘤的安全性相似。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.