新型冠状病毒性肺炎症状有哪些

立体定向消融放疗(SAbR)可提高非小细胞肺癌患者生存期达三倍!

编译:肿瘤资讯-小编 来源:肿瘤资讯

2017年的美国放射治疗年会在圣地亚哥举行,维持化学疗法之前立体定向消融放疗(SAbR)的固化治疗与单纯维持化疗相比,局限期的非小细胞肺癌(NSCLC)患者的无进展生存期(PFS)几乎翻了三倍。该文章也发表在JAMA Oncology上。

立体定向消融放疗(SAbR)可提高非小细胞肺癌患者生存期达三倍!

一项II期研究表明在维持化学疗法之前使用立体定向消融放疗(SAbR)的治疗方法与单纯维持化疗相比,可使局限期非小细胞肺癌(NSCLC)患者的无进展生存期(PFS)几乎翻了三倍。

该研究的作者Iyengar博士是得克萨斯大学达拉斯西南医学中心放射肿瘤学教授和助理教授,在美国辐射肿瘤学会(ASTRO)2017年会议的全体会议上介绍了改研究的结果。

该研究显示,在局限性性NSCLC患者的患者中,SAbR组的PFS增加从3.5到9.7个月有统计学意义的改善, 0.113-0.815; P = 0.01)。

主要作者Puneeth Iyengar博士说:“PFS几乎增加了三倍,我们希望它与整体生存相关,但在分析时,总体生存期尚未达到。”。

立体定向消融放疗(SAbR)可提高非小细胞肺癌患者生存期达三倍!

摘要:

Consolidative Radiotherapy for Limited Metastatic Non–Small-Cell Lung Cancer:A Phase 2 Randomized Clinical Trial

Puneeth Iyengar, MD, PhD1; Zabi Wardak, MD1; David E. Gerber, MD2; et al Vasu Tumati, MD1; Chul Ahn, PhD3; Randall S. Hughes, MD2; Jonathan E. Dowell, MD2; Naga Cheedella, MD2; Lucien Nedzi, MD1; Kenneth D. Westover, MD, PhD1; Suprabha Pulipparacharuvil, PhD1; Hak Choy, MD1; Robert D. Timmerman, MD1

Author Affiliations

JAMA Oncol. Published online September 24, 2017. doi:10.1001/jamaoncol.2017.3501

Importance Patterns-of-failure studies suggest that in metastatic non–small-cell lung cancer (NSCLC) sites of gross disease at presentation are the first to progress when treated with chemotherapy. This knowledge has led to increased adoption of local ablative radiation therapy in patients with stage IV NSCLC, though prospective randomized evidence is limited.

Objective To determine if intervening with noninvasive stereotactic ablative radiotherapy (SAbR) prior to maintenance chemotherapy in patients with non–progressive limited metastatic NSCLC after induction therapy led to significant improvements in progression-free survival (PFS).

Design, Setting, and Participants This is a single-institution randomized phase 2 study of maintenance chemotherapy alone vs SAbR followed by maintenance chemotherapy for patients with limited metastatic NSCLC (primary plus up to 5 metastatic sites) whose tumors did not possess EGFR-targetable or ALK-targetable mutations but did achieve a partial response or stable disease after induction chemotherapy.

Interventions Maintenance chemotherapy or SAbR to all sites of gross disease (including SAbR or hypofractionated radiation to the primary) followed by maintenance chemotherapy.

Main Outcomes and Measures The primary end point was PFS; secondary end points included toxic effects, local and distant tumor control, patterns of failure, and overall survival.

Results A total of 29 patients (9 women and 20 men) were enrolled; 14 patients (median [range] age, 63.5 [51.0-78.0] years) were allocated to the SAbR-plus-maintenance chemotherapy arm, and 15 patients (median [range] age, 70.0 [51.0-79.0] years) were allocated to the maintenance chemotherapy–alone arm. The trial was stopped to accrual early after an interim analysis found a significant improvement in PFS in the SAbR-plus-maintenance chemotherapy arm of 9.7 months vs 3.5 months in the maintenance chemotherapy–alone arm (P = .01). Toxic effects were similar in both arms. There were no in-field failures with fewer overall recurrences in the SAbR arm while those patients receiving maintenance therapy alone had progression at existing sites of disease and distantly.

Conclusions and Relevance Consolidative SAbR prior to maintenance chemotherapy appeared beneficial, nearly tripling PFS in patients with limited metastatic NSCLC compared with maintenance chemotherapy alone, with no difference in toxic effects. The irradiation prevented local failures in original disease, the most likely sites of first recurrence. Furthermore, PFS for patients with limited metastatic disease appeared similar to those patients with a greater metastatic burden, further arguing for the potential benefits of local therapy in limited metastatic settings.

Trial Registration clinicaltrials.gov Identifier: NCT02045446

责任编辑:肿瘤资讯-小编

立体定向消融放疗(SAbR)可提高非小细胞肺癌患者生存期达三倍!

发表评论

您的电子邮件地址将不会发布。

此站点使用Akismet来减少垃圾评论。了解我们如何处理您的评论数据