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IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-03 DOI: 10.1016/S0167-8140(24)00758-8
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引用次数: 0
Impact of mediastinal tumor burden and lymphatic spread in locally advanced non-small-cell lung cancer: A secondary analysis of the multicenter randomized PET-Plan trial 纵隔肿瘤负荷和淋巴扩散对局部晚期非小细胞肺癌的影响：多中心随机 PET-Plan 试验的二次分析。
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-03 DOI: 10.1016/j.radonc.2024.110521

Purpose

The aim of this secondary analysis of the prospective randomized phase 2 PET-Plan trial (ARO-2009-09; NCT00697333) was to evaluate the impact of mediastinal tumor burden and lymphatic spread in patients with locally advanced non-small-cell lung cancer (NSCLC).

Methods

All patients treated per protocol (n = 172) were included. Patients received isotoxically dose-escalated chemoradiotherapy up to a total dose of 60–74 Gy in 30–37 fractions, aiming as high as possible while adhering to normal tissue constraints. Radiation treatment (RT) planning was based on an 18F-FDG PET/CT targeting all lymph node (LN) stations containing CT positive LNs (i.e. short axis diameter > 10 mm), even if PET-negative (arm A) or targeting only LN stations containing PET-positive nodes (arm B). LN stations were classified into echelon 1 (ipsilateral hilum), 2 (ipsilateral station 4 and 7), and 3 (rest of the mediastinum, contralateral hilum). The endpoints were overall survival (OS), progression-free survival (PFS), and freedom from local progression (FFLP).

Results

The median follow-up time (95 % confidence interval [CI]) was 41.1 (33.8 − 50.4) months. Patients with a high absolute number of PET-positive LN stations had worse OS (hazard ratio [HR] = 1.09; 95 % CI 0.99 − 1.18; p = 0.05) and PFS (HR = 1.12; 95 % CI 1.04 − 1.20; p = 0.003), irrespective of treatment arm allocation. The prescribed RT dose to the LNs did not correlate with any of the endpoints when considering all patients. However, in patients in arm B (i.e., PET-based selective nodal irradiation), prescribed RT dose to each LN station correlated significantly with FFLP (HR=0.45; 95 % CI 0.24–0.85; p = 0.01). Furthermore, patients with involvement of echelon 3 LN stations had worse PFS (HR = 2.22; 95 % CI 1.16–4.28; p = 0.02), also irrespective of allocation.

Conclusion

Mediastinal tumor burden and lymphatic involvement patterns influence outcome in patients treated with definitive chemoradiotherapy for locally advanced NSCLC. Higher dose to LNs did not improve OS, but did improve FFLP in patients treated with PET-based dose-escalated RT.

目的：这项对前瞻性随机 2 期 PET-Plan 试验（ARO-2009-09；NCT00697333）的二次分析旨在评估纵隔肿瘤负荷和淋巴扩散对局部晚期非小细胞肺癌（NSCLC）患者的影响：方法：纳入所有按方案接受治疗的患者（n = 172）。患者接受等毒性剂量递增的化放疗，总剂量为60-74 Gy，分30-37次进行，在遵守正常组织限制的前提下尽量提高剂量。放射治疗（RT）计划以18F-FDG PET/CT为基础，靶向所有含有CT阳性淋巴结（即短轴直径大于10毫米）的淋巴结站，即使PET阴性（A组）或仅靶向含有PET阳性淋巴结的淋巴结站（B组）。LN站被分为第1梯队（同侧腹股沟）、第2梯队（同侧第4和第7站）和第3梯队（纵隔其余部分、对侧腹股沟）。终点为总生存期（OS）、无进展生存期（PFS）和无局部进展（FFLP）：中位随访时间（95% 置信区间 [CI]）为 41.1 (33.8 - 50.4) 个月。PET阳性LN站绝对数量较多的患者的OS（危险比[HR] = 1.09; 95 % CI 0.99 - 1.18; p = 0.05）和PFS（HR = 1.12; 95 % CI 1.04 - 1.20; p = 0.003）较差，与治疗臂的分配无关。考虑到所有患者，对淋巴结的规定 RT 剂量与任何终点均无相关性。但是，在B组（即基于PET的选择性结节照射）患者中，每个LN站的处方RT剂量与FFLP显著相关（HR=0.45；95 % CI 0.24-0.85；p = 0.01）。此外，第3梯队LN站受累的患者PFS较差（HR = 2.22; 95 % CI 1.16-4.28; p = 0.02），这也与分配无关：结论：纵隔肿瘤负荷和淋巴受累模式会影响局部晚期NSCLC明确化放疗患者的预后。在接受基于 PET 的剂量递增 RT 治疗的患者中，增加淋巴结的剂量并不能改善 OS，但却能改善 FFLP。
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引用次数: 0
Call For Papers: Radiotherapy & Oncology and The Lancet Oncology collaboration 论文征集：放射治疗与肿瘤学》杂志与《柳叶刀肿瘤学》杂志合作。
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-02 DOI: 10.1016/j.radonc.2024.110504
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引用次数: 0
23 Stereotactic Body Versus Conventional Fractionation External Beam Radiotherapy (EBRT) Boost for High-Risk Prostate Cancer (HR-PC); Early Results of PBS: A Phase II Randomized Trial (NCT03380806) 23 高危前列腺癌（HR-PC）的立体定向体外放射治疗（EBRT）与传统分次体外放射治疗（PBS）的早期结果：II期随机试验（NCT03380806）
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03679-X
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引用次数: 0
39 Dosimetric Predictors of Toxicity and Local Control of Single-Fraction SABR for Non-Small Cell Lung Cancer 39 非小细胞肺癌单病灶 SABR 治疗毒性和局部控制的剂量预测指标
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03695-8
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引用次数: 0
57 Association of Absolute Amount of Pattern 4 Disease on Prostate Biopsy with Oncologic Outcomes in Intermediate-Risk Prostate Cancer: A Systematic Review 57 前列腺活检第 4 型病变的绝对数量与中危前列腺癌的肿瘤学结果的关系：系统回顾
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03713-7
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引用次数: 0
70 Retrospective Analysis of Patients Treated with HDR Brachytherapy for Prostate Cancer 70 例接受 HDR 近距离放射治疗的前列腺癌患者回顾性分析
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03726-5
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引用次数: 0
33 Radiotherapy Availability and Public Awareness: A Comparative Analysis Across Health Systems 33 放射治疗的可用性和公众意识：不同卫生系统的比较分析
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03689-2
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引用次数: 0
49 Stereotactic Ablative Radiotherapy for Oligoprogressive Solid Tumours: A Systematic Review and Meta-Analysis 49 立体定向消融放疗治疗寡进展性实体瘤：系统回顾和元分析
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03705-8
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引用次数: 0
4 Treatment Toxicity and Outcomes Following Definitive Radiotherapy for Patients with Early-Stage Non-Small Cell Lung Cancers and Pre-Existing Interstitial Lung Disease: A Systematic Review 4 早期非小细胞肺癌和既往肺间质疾病患者接受确定性放疗后的治疗毒性和疗效：系统回顾
IF 4.9 1区 医学 Q1 ONCOLOGY
Radiotherapy and Oncology
Pub Date : 2024-09-01 DOI: 10.1016/S0167-8140(24)03578-3
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引用次数: 0
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