Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT.
Radiother Oncol
; 134: 191-198, 2019 05.
Article
em En
| MEDLINE
| ID: mdl-31005215
ABSTRACT
BACKGROUND:
Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. MATERIALS ANDMETHODS:
Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4â¯cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed.RESULTS:
We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1-3.0â¯cm (T1-size), and 63 patients were with tumors of 3.1-4.0â¯cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact- or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact- (17.6% (95% confidence interval (CI), 10.7-25.9%) vs. 6.6% (95% CI, 3.5-11.1%), pâ¯<â¯0.01), and 58.2% (95% CI, 47.6-67.5%) vs. 77.6% (95% CI, 70.5-83.2%), pâ¯<â¯0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95% CI, 1.09-3.52; pâ¯=â¯0.03) and overall survival (HR, 1.59; 95% CI, 1.08-2.34; pâ¯=â¯0.02).CONCLUSION:
Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pleura
/
Carcinoma Pulmonar de Células não Pequenas
/
Neoplasias Pulmonares
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article