{"title":"日本真实世界中可切除临床 III 期非小细胞肺癌的治疗模式和临床结果：SOLUTION研究的手术队列分析。","authors":"Masahiro Tsuboi, Haruyasu Murakami, Hideyuki Harada, Tomotaka Sobue, Tomohiro Kato, Shinji Atagi, Takaaki Tokito, Tadashi Mio, Hirofumi Adachi, Toshiyuki Kozuki, Takashi Sone, Masahiro Seike, Shinichi Toyooka, Hiroshi Kitagawa, Ryo Koto, Satoshi Yamazaki, Hidehito Horinouchi","doi":"10.1111/1759-7714.15305","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To elucidate the treatment and surgery outcomes with or without perioperative therapies in Japanese patients with clinical stage III non-small cell lung cancer (NSCLC) in real-world settings.</p><p><strong>Methods: </strong>We performed subset analyses of the SOLUTION study, a multicenter, noninterventional, observational study of Japanese patients diagnosed with clinical stage III NSCLC, for those who started first-line treatment (surgery±perioperative therapy) between January 2013 and December 2014 (study registration: UMIN000031385). Follow-up data were obtained using medical records from diagnosis to March 1, 2018.</p><p><strong>Results: </strong>Of 149 eligible patients, 67 underwent surgery alone (median age 71 years) and 82 underwent surgery+perioperative therapy (median age 63 years). Lung resection was performed in 137 patients and the others underwent exploratory thoracotomy or other procedures. Perioperative therapies included adjuvant therapy only (n = 41), neoadjuvant therapy only (n = 24), and neoadjuvant+adjuvant therapy (n = 17). The median overall survival (OS) and 3-year OS rate were 29.3 months and 44.0%, respectively, in patients who underwent surgery alone, and not reached and 61.1%, respectively, in patients who underwent surgery+perioperative therapy. The 3-year progression-free survival (PFS) and disease-free survival (DFS) rates were 42.4% and 47.1%, respectively, in patients who underwent surgery+perioperative therapy and 28.5% and 28.9%, respectively, in patients who underwent surgery alone. In multivariable Cox regression, perioperative therapy was associated with improved OS (hazard ratio [95% confidence interval] 0.49 [0.29-0.81]), PFS (0.62 [0.39-0.96]), and DFS (0.62 [0.39-0.97]) versus surgery alone.</p><p><strong>Conclusions: </strong>Our study suggested that perioperative therapy may be associated with better survival among patients undergoing surgical treatment of clinical stage III NSCLC.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246785/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment patterns and clinical outcomes of resectable clinical stage III non-small cell lung cancer in a Japanese real-world setting: Surgery cohort analysis of the SOLUTION study.\",\"authors\":\"Masahiro Tsuboi, Haruyasu Murakami, Hideyuki Harada, Tomotaka Sobue, Tomohiro Kato, Shinji Atagi, Takaaki Tokito, Tadashi Mio, Hirofumi Adachi, Toshiyuki Kozuki, Takashi Sone, Masahiro Seike, Shinichi Toyooka, Hiroshi Kitagawa, Ryo Koto, Satoshi Yamazaki, Hidehito Horinouchi\",\"doi\":\"10.1111/1759-7714.15305\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To elucidate the treatment and surgery outcomes with or without perioperative therapies in Japanese patients with clinical stage III non-small cell lung cancer (NSCLC) in real-world settings.</p><p><strong>Methods: </strong>We performed subset analyses of the SOLUTION study, a multicenter, noninterventional, observational study of Japanese patients diagnosed with clinical stage III NSCLC, for those who started first-line treatment (surgery±perioperative therapy) between January 2013 and December 2014 (study registration: UMIN000031385). Follow-up data were obtained using medical records from diagnosis to March 1, 2018.</p><p><strong>Results: </strong>Of 149 eligible patients, 67 underwent surgery alone (median age 71 years) and 82 underwent surgery+perioperative therapy (median age 63 years). Lung resection was performed in 137 patients and the others underwent exploratory thoracotomy or other procedures. Perioperative therapies included adjuvant therapy only (n = 41), neoadjuvant therapy only (n = 24), and neoadjuvant+adjuvant therapy (n = 17). The median overall survival (OS) and 3-year OS rate were 29.3 months and 44.0%, respectively, in patients who underwent surgery alone, and not reached and 61.1%, respectively, in patients who underwent surgery+perioperative therapy. The 3-year progression-free survival (PFS) and disease-free survival (DFS) rates were 42.4% and 47.1%, respectively, in patients who underwent surgery+perioperative therapy and 28.5% and 28.9%, respectively, in patients who underwent surgery alone. 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引用次数: 0
摘要
背景：旨在阐明日本临床Ⅲ期非小细胞肺癌（NSCLC）患者在实际情况下接受或不接受围手术期治疗的治疗和手术效果：目的：阐明日本临床Ⅲ期非小细胞肺癌（NSCLC）患者在实际情况下接受或不接受围手术期治疗的治疗和手术效果：我们对2013年1月至2014年12月期间开始一线治疗（手术+围手术期治疗）的日本临床III期非小细胞肺癌患者进行了子集分析（研究注册号：UMIN000031385）。随访数据通过从诊断到2018年3月1日的医疗记录获得：在149名符合条件的患者中，67人单独接受了手术（中位年龄71岁），82人接受了手术+围手术期治疗（中位年龄63岁）。137名患者进行了肺切除术，其他患者进行了探查性开胸术或其他手术。围手术期疗法包括仅辅助治疗（41例）、仅新辅助治疗（24例）和新辅助+辅助治疗（17例）。单纯手术患者的中位总生存期（OS）和3年OS率分别为29.3个月和44.0%，手术+围手术期治疗患者的中位总生存期和3年OS率分别为61.1%和29.3个月。接受手术+围手术期治疗的患者的3年无进展生存期（PFS）和无疾病生存期（DFS）分别为42.4%和47.1%，而单独接受手术的患者的3年无进展生存期和无疾病生存期分别为28.5%和28.9%。在多变量Cox回归中，与单纯手术相比，围手术期治疗与OS（危险比[95%置信区间]0.49 [0.29-0.81]）、PFS（0.62 [0.39-0.96]）和DFS（0.62 [0.39-0.97]）的改善相关：我们的研究表明，围手术期治疗可能与临床 III 期 NSCLC 手术治疗患者的生存率提高有关。
Treatment patterns and clinical outcomes of resectable clinical stage III non-small cell lung cancer in a Japanese real-world setting: Surgery cohort analysis of the SOLUTION study.
Background: To elucidate the treatment and surgery outcomes with or without perioperative therapies in Japanese patients with clinical stage III non-small cell lung cancer (NSCLC) in real-world settings.
Methods: We performed subset analyses of the SOLUTION study, a multicenter, noninterventional, observational study of Japanese patients diagnosed with clinical stage III NSCLC, for those who started first-line treatment (surgery±perioperative therapy) between January 2013 and December 2014 (study registration: UMIN000031385). Follow-up data were obtained using medical records from diagnosis to March 1, 2018.
Results: Of 149 eligible patients, 67 underwent surgery alone (median age 71 years) and 82 underwent surgery+perioperative therapy (median age 63 years). Lung resection was performed in 137 patients and the others underwent exploratory thoracotomy or other procedures. Perioperative therapies included adjuvant therapy only (n = 41), neoadjuvant therapy only (n = 24), and neoadjuvant+adjuvant therapy (n = 17). The median overall survival (OS) and 3-year OS rate were 29.3 months and 44.0%, respectively, in patients who underwent surgery alone, and not reached and 61.1%, respectively, in patients who underwent surgery+perioperative therapy. The 3-year progression-free survival (PFS) and disease-free survival (DFS) rates were 42.4% and 47.1%, respectively, in patients who underwent surgery+perioperative therapy and 28.5% and 28.9%, respectively, in patients who underwent surgery alone. In multivariable Cox regression, perioperative therapy was associated with improved OS (hazard ratio [95% confidence interval] 0.49 [0.29-0.81]), PFS (0.62 [0.39-0.96]), and DFS (0.62 [0.39-0.97]) versus surgery alone.
Conclusions: Our study suggested that perioperative therapy may be associated with better survival among patients undergoing surgical treatment of clinical stage III NSCLC.
期刊介绍：
Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society.
The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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