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Front Oncol: Exploring the optimal time point for local radiotherapy in patients with unresectable lung adenocarcinoma

 Last Update: 2022-03-04
 Source: Internet
 Author: User

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There is growing evidence that local radiotherapy (LRT) is beneficial for survival in advanced non-small cell lung cancer (NSCLC), but studies on the optimal timing of initial treatment remain scarce
.

Therefore, a domestic team carried out a related study to evaluate the optimal time point for local radiotherapy (LRT) in patients with stage IIIb-IV unresectable lung adenocarcinoma

There is growing evidence that local radiotherapy (LRT) is beneficial for survival in advanced non-small cell lung cancer (NSCLC), but studies on the optimal timing of initial treatment remain scarce

Patients were divided into two groups: early radiotherapy group (≤53 days, EAR group) and delayed radiotherapy group (>53 days, DEF group)
.

The Kaplan Meier method was used to estimate time to event endpoint; Cox proportional hazards models were used to identify predictors of progression-free survival (PFS) and overall survival (OS)

Patients were divided into two groups: early radiotherapy group (≤53 days, EAR group) and delayed radiotherapy group (>53 days, DEF group)

A total of 265 patients were included , with a median age of 57 years

The median follow-up time was 26.

The mOS of patients under 60 years old was 47.
3 (95% CI, 34.
3-60.
4) and 27.
7 (95% CI, 19.
0-36.
5) months, respectively, the OS of the former was significantly better than that of the latter (HR 2.
14, 95% CI, 1.
27 3.
59 , p = 0.
005)
.

Patients with KPS scores above 90, 80, and 70 had mOS of 47.

The mOS of patients under 60 years old was 47.

mOS was 41.

Interestingly, for patients with bone metastases, mOS was significantly improved with early RT compared with delayed RT (56.
7 vs 17.
5 months, HR 4.
46, 95% CI 1.
28 15.
61, p = 0.
005)
.

Interestingly, for patients with bone metastases, mOS was significantly improved with early RT compared with delayed RT (56.

In patients with EGFR mutations, there was no significant difference in PFS (HR 0.
71, 95%CI 0.
45 1.
14p=0.
12) and OS (HR 1.
38, 95%CI 0.
71 2.
70 p=0.
357) between the EAR group and the DEF group
.

In patients with EGFR mutations, there was no significant difference in PFS (HR 0.

In multivariate analysis, KPS ≧80 (HR 1.
30, 95% CI 0.
95 1.
76, p = 0.
09), T2 (HR 1.
46, 95% CI 0.
96 2.
22, p = 0.
07) and time to radiotherapy initiation (HR 1.
92, 95%) CI 1.
39 2.
66, p

In multivariate analysis, KPS ≧80 (HR 1.
30, 95% CI 0.
95 1.
76, p = 0.
09), T2 (HR 1.
46, 95% CI 0.
96 2.
22, p = 0.
07) and time to radiotherapy initiation (HR 1.
92, 95%) CI 1.
39 2.
66, p In multivariate analysis, KPS ≥ 80 (HR 1.
30, 95% CI 0.
95 1.
76, p = 0.
09), T2 (HR 1.
46, 95% CI 0.
96 2.
22, p = 0.
07) and time to radiotherapy treatment initiation ( HR 1.
92, 95% CI 1.
39 2.
66, p

In multivariate analysis, older than 60 years (HR 1.
48, 95% CI 0.
94 2.
31, p = 0.
08), bone and brain metastases (HR 2.
77, 95% CI 1.
16 6.
6, p = 0.
02), and multisite metastases (HR 2.
06, 95% CI 1.
01 4.
21, p = 0.
04) was an independent predictor of shorter OS
.
EGFR 19 mutation is a good prognostic indicator for OS
.
In multivariate analysis, older than 60 years (HR 1.
48, 95% CI 0.
94 2.
31, p = 0.
08), bone and brain metastases (HR 2.
77, 95% CI 1.
16 6.
6, p = 0.
02), and multisite metastases (HR 2.
06, 95% CI 1.
01 4.
21, p = 0.
04) was an independent predictor of shorter OS
.
EGFR 19 mutation is a good prognostic indicator for OS
.

In conclusion, the study showed that starting radiotherapy early after diagnosis (≤53 days) improved PFS in patients with unresectable lung adenocarcinoma, but there was no difference in OS
.
Patients with bone metastases were more likely to benefit from OS from early radiotherapy
.
Studies have shown that starting radiotherapy early after diagnosis (≤53 days) improves PFS in patients with unresectable lung adenocarcinoma, but there is no difference in OS
.
Patients with bone metastases were more likely to benefit from OS from early radiotherapy
.
Studies have shown that starting radiotherapy early after diagnosis (≤53 days) improves PFS in patients with unresectable lung adenocarcinoma, but there is no difference in OS
.
Patients with bone metastases were more likely to benefit from OS from early radiotherapy
.

Original source:

Li X, Wang J, Chang X, Gao Z, Teng F, Meng X and Yu J (2022) Optimal Initial Time Point of Local Radiotherapy for Unresectable Lung Adenocarcinoma: A Retrospective Analysis on Overall Arrangement of Local Radiotherapy in Advanced Lung Adenocarcinoma.
Front .
Oncol.
12:793190.
doi: 10.
3389/fonc.
2022.
793190

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