Background
Methods
Inclusion and exclusion criteria
Pre- and post-treatment assessment
General clinical data
Variable | <63 Gy | ≥63 Gy |
χ
2
|
p
|
---|---|---|---|---|
Gender | ||||
Male | 33 | 53 | 2.387 | 0.122 |
Female | 8 | 26 | ||
Age (years) | ||||
<65 | 27 | 55 | 0.177 | 0.674 |
≥65 | 14 | 24 | ||
Pathological type | ||||
Squamous | 17 | 23 | 5.268 | 0.072 |
Adenocarcinoma | 18 | 51 | ||
Other types | 6 | 5 | ||
T stage | ||||
T1 | 3 | 7 | 2.371 | 0.499 |
T2 | 17 | 23 | ||
T3 | 6 | 10 | ||
T4 | 15 | 39 | ||
N stage | ||||
N0 | 3 | 5 | 2.631#
| 0.444 |
N1 | 2 | 10 | ||
N2 | 14 | 31 | ||
N3 | 22 | 33 | ||
GTV (cm3) | 23.64 ~ 892.00 (204.91) | 16.55 ~ 617.50 (160.51) | 1.108* | 0.171 |
Chemotherapy | ||||
2-3 cycles | 23 | 23 | 8.314 | 0.004 |
4-5 cycles | 18 | 56 | ||
Range (median) | 2-4 (3) | 2-5 (4) | ||
Organ metastases | ||||
Single organ | 27 | 54 | 0.077 | 0.781 |
Multi-organ | 14 | 25 | ||
Treatment response of primary tumor | ||||
CR | 1 | 10 | 3.961 | 0.138 |
PR | 32 | 59 | ||
NC | 8 | 10 |
Chemotherapy protocol
Radiotherapy protocol
Evaluation of therapeutic efficacy
Follow-up and statistical analyses
Results
Differential treatment response of primary tumors
Comparison of LRPFS according to treatment responses of primary tumors
Variable | No. | Survival rate (%) | Median survival time (months) | 95% confidence interval |
χ
2
|
p
| ||||
---|---|---|---|---|---|---|---|---|---|---|
1 year | 2 year | 3 year | 5 year | |||||||
CR | 11 | 63.6 | 42.4 | 31.8 | 31.8 | 20 | 8.5 | 31.5 | 2.065 | 0.356 |
PR | 91 | 58.3 | 27.5 | 18.3 | 0 | 15 | 11.5 | 18.5 | ||
SD | 18 | 50.0 | 35.7 | 26.8 | 26.8 | 10 | 1.9 | 18.1 | ||
CR | 11 | 63.6 | 42.4 | 31.8 | 31.8 | 20 | 8.5 | 31.5 | 1.922 | 0.166 |
PR + SD | 109 | 56.9 | 29.0 | 19.7 | 7.8 | 15 | 11.9 | 18.1 |
LRPFS according to radiation doses to primary tumors
Assessment of LRPFS in patients who received concurrent chemotherapy and various doses of radiation to primary tumors
Cycle | Dose (Gy) | No. | Survival rate (%) | Median survival (months) | 95% confidence interval |
χ
2
|
p
| ||||
---|---|---|---|---|---|---|---|---|---|---|---|
1 year | 2 year | 3 year | 5 year | ||||||||
2-3 | <63 | 23 | 41.7 | 27.8 | 20.9 | 0 | 10 | 5.5 | 14.5 | 0.040 | 0.842 |
≥63 | 23 | 43.5 | 26.1 | 19.6 | 0 | 9 | 4.3 | 13.7 | |||
4-5 | <63 | 18 | 32.6 | 21.7 | 0 | 0 | 9 | 6.6 | 11.4 | 9.217 | 0.002 |
≥63 | 56 | 77.4 | 36.2 | 27.2 | 15.9 | 20 | 16.5 | 23.5 |
Effect of various combined chemoradiotherapy regimens on LRPFS and OS
Cox regression analyses
Variable | OS | LRPFS | ||||
---|---|---|---|---|---|---|
p
| HR | 95% CI |
p
| HR | 95% CI | |
Gender (Female vs. Male) | 0.288 | 0.802 | 0.534-1.205 | 0.278 | 0.753 | 0.450-1.258 |
Age (years) (≥65 vs. <65) | 0.297 | 0.817 | 0.558-1.195 | 0.248 | 0.760 | 0.477-1.211 |
Pathological type (Non-squamous vs. Squamous) | 0.106 | 1.364 | 0.936-1.988 | 0.494 | 1.184 | 0.729-1.924 |
T stage (T3-T4 vs. T1-T2) | 0.728 | 1.067 | 0.740-1.540 | 0.702 | 1.097 | 0.684-1.759 |
Distant metastatic lesions (No radiotherapy vs. Radiotherapy) | 0.682 | 1.083 | 0.740-1.584 | 0.652 | 1.118 | 0.689-1.812 |
Intrathoracic primary tumors (No response vs. Response) | 0.592 | 1.124 | 0.733-1.724 | 0.581 | 1.188 | 0.644-2.190 |
GTV (<175 cm3 vs. ≥175 cm3) | 0.008 | 1.747 | 1.153-2.646 | 0.003 | 2.321 | 1.336-4.032 |
Post-treatment KPS (Decreased ≥10 vs. Stable or increased ≥10) | 0.000 | 6.282 | 3.568-11.058 | 0.000 | 8.038 | 3.769-17.140 |
N stage (N2-N3vs. N0-N1) | 0.059 | 1.636 | 0.981-2.727 | 0.234 | 1.438 | 0.790-2.615 |
Chemotherapy cycles (2–3 vs. 4–5) | 0.035 | 1.484 | 1.028-2.144 | 0.128 | 1.431 | 0.903-2.268 |
Intrathoracic primary tumors radiation doses (<63Gy vs. ≥63Gy) | 0.057 | 1.433 | 0.989-2.075 | 0.051 | 1.562 | 0.999-2.443 |