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Significant reduction of oncologic pulmonary death by local control for pulmonary oligometastases treated with stereotactic body radiotherapy
Radiotherapy and Oncology ( IF 5.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.radonc.2020.03.019
Takaya Yamamoto 1 , Yuzuru Niibe 2 , Kazunari Yamada 3 , Masahiko Aoki 4 , Hiroshi Onishi 5 , Kuniaki Katsui 6 , Yasuhiro Dekura 7 , Atsushi Nishikawa 8 , Yoshihiko Manabe 9 , Hideomi Yamashita 10 , Keiichi Jingu 1
Affiliation  

BACKGROUND AND PURPOSE The rate of oncologic pulmonary death after stereotactic body radiotherapy for pulmonary oligometastases has never been reported. The purpose of current study was to investigate the rate of freedom from oncologic pulmonary death (FOPD) and to analyze factors affecting for FOPD. MATERIALS AND METHODS The inclusion criteria for this retrospective study were that SBRT was performed between 2004 and 2015, the number of metastases was 5 or less, the primary lesion and extrathoracic metastases needed to be controlled before SBRT and a biological effective dose (BED10) of 75 Gy or more was needed. The Kaplan-Meier estimator and the log-rank test were used to calculate and compare the stratified rates of FOPD. The Cox proportional hazards model was used for multivariate analyses (MVA). Primary disease death from a non-oncologic pulmonary cause was censored in model 1 and was excluded in model 2. RESULTS A total of 1172 patients with 1315 tumors were enrolled. During a median follow-up period of 24.5 months, oncologic pulmonary deaths accounted for 101 of 221 primary disease deaths. The 1-year, 3-year and 5-year FOPD rates in model 1 were 98.2%, 89.4% and 84.0%, respectively. MVA for FOPD revealed that local failure of the irradiated tumor, squamous cell carcinoma pathology, and chemotherapy after SBRT had significant relationships with lower FOPD rates in both model 1 and model 2. CONCLUSIONS Successful local control of pulmonary oligometastases by SBRT contributed to a higher FOPD rate.

中文翻译:

通过局部控制立体定向放疗治疗肺寡转移,显着减少肿瘤性肺死亡

背景和目的 立体定向放疗治疗肺寡转移瘤后肺肿瘤死亡率从未有过报道。本研究的目的是调查无肿瘤肺死亡 (FOPD) 的比率并分析影响 FOPD 的因素。材料与方法 本回顾性研究的纳入标准为 2004 年至 2015 年间进行 SBRT,转移灶数在 5 个或以下,SBRT 前需控制原发灶和胸腔外转移灶,生物有效剂量(BED10)为需要 75 Gy 或更多。Kaplan-Meier 估计量和对数秩检验用于计算和比较 FOPD 的分层率。Cox 比例风险模型用于多变量分析 (MVA)。非肿瘤性肺部原因导致的原发疾病死亡在模型 1 中被截尾,并在模型 2 中被排除。结果 共有 1172 名患者参与了 1315 个肿瘤。在 24.5 个月的中位随访期间,221 例原发性疾病死亡中有 101 例死于肿瘤性肺部疾病。模型 1 中的 1 年、3 年和 5 年 FOPD 率分别为 98.2%、89.4% 和 84.0%。FOPD 的 MVA 显示 SBRT 后受照射肿瘤、鳞状细胞癌病理学和化疗的局部失败与模型 1 和模型 2 中较低的 FOPD 发生率显着相关。结论 SBRT 成功局部控制肺寡转移有助于较高的 FOPD速度。在 24.5 个月的中位随访期间,221 例原发性疾病死亡中有 101 例死于肿瘤性肺部疾病。模型 1 中的 1 年、3 年和 5 年 FOPD 率分别为 98.2%、89.4% 和 84.0%。FOPD 的 MVA 显示 SBRT 后受照射肿瘤、鳞状细胞癌病理学和化疗的局部失败与模型 1 和模型 2 中较低的 FOPD 发生率显着相关。结论 SBRT 成功局部控制肺寡转移有助于较高的 FOPD速度。在 24.5 个月的中位随访期间,221 例原发性疾病死亡中有 101 例死于肿瘤性肺部疾病。模型 1 中的 1 年、3 年和 5 年 FOPD 率分别为 98.2%、89.4% 和 84.0%。FOPD 的 MVA 显示 SBRT 后受照射肿瘤、鳞状细胞癌病理学和化疗的局部失败与模型 1 和模型 2 中较低的 FOPD 发生率显着相关。结论 SBRT 成功局部控制肺寡转移有助于较高的 FOPD速度。
更新日期:2020-06-01
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