Efficacy and safety of systemic treatment combined with local consolidative radiation therapy to primary tumor and all oligometastatic sites for elderly patients with synchronous oligometastatic non-small cell lung cancer
Year: 2021
Type: preprint
Study design: Observational Study
Abstract: Objective Our objective is to implement local consolidative radiation therapy (LCRT) to the primary tumors and all oligometastatic sites in elderly patients with synchronous oligometastatic NSCLC and evaluate its long-term efficacy and safety.Patients and Methods All patients were older than 65 years at initial diagnosis and had pathologically confirmed NSCLC with a total of less than or equal to 5 metastases through imaging diagnosis. LCRT to the primary tumors and all oligometastatic sites to evaluate its OS, PFS, and toxicity.Results A total of 115 elderly patients with synchronous oligometastatic NSCLC (≤ 5 metastases) were enrolled, including 33 elderly patients who received LCRT to the primary tumors and all oligometastatic sites (all-LCRT group), 38 elderly patients who received LCRT to either primary tumor or oligometastatic sites (part-LCRT group) and 44 elderly patients did not receive any LCRT (non- LCRT group). The median follow-up time was 34 months. The median progression-free survival (PFS) was 12 months for all-LCRT group, 9 months for part-LCRT group, and 6 months for non-LCRT group (p<0.001). The median overall survival (OS) in All-LCRT group, Part-LCRT group, and non-LCRT group was 28 months, 21 months, and 13 months, respectively (p<0.001). The survival differences among the three groups reached statistical significance for the survival analyses. Multivariate Cox regression analysis indicated that LCRT for primary tumor (HR=0.21, 95%CI: 0.12-0.36, p<0.001), good ECOG PS (HR=0.51, 95%CI: 0.33-0.79, p=0.003), T1-2 stage (HR=0.59, 95%CI: 0.37-0.93, p=0.023), and peripheral lung cancer (HR=0.63, 95%CI: 0.41-0.97, p=0.036) were independent prognostic factors for better OS. Most patients experienced grade 1-2 toxicity, very few had grade 3 toxicity, no grade 4 or higher toxicity occurred, and no treatment-related death occurred.Conclusion Elderly patients with synchronous oligometastatic NSCLC were treated with LCRT to the primary tumors and all oligometastatic sites, which may improve their survival with tolerable toxicity.
Source: Research Square
Authors: Xiaolong Hu, Hongqi Li, Hefei Liu, Xiaoli Kang, Xuan Wang, Haifeng Pang, Chen Liu, Jianchun Zhang, Yingjie Wang
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4200211045