Higher Lung and Heart Doses Decrease Early and Long-Term Survival, Respectively, in Patients With Non-Small Cell Lung Cancer Undergoing Postoperative Radiation

被引：11

作者：

Ma, Zeliang ^{[1
]}

Liu, Yunsong ^{[1
]}

Bao, Yongxing ^{[1
]}

Yuan, Meng ^{[1
]}

Yang, Xu ^{[2
]}

Men, Yu ^{[3
]}

Wang, Jianyang ^{[1
]}

Deng, Lei ^{[1
]}

Zhai, Yirui ^{[1
]}

Bi, Nan ^{[1
]}

Wang, Luhua ^{[1
]}

Hui, Zhouguang ^{[1
,3
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Natl Clin Res Ctr Canc, Dept Radiat Oncol,Canc Hosp, Beijing, Peoples R China

[2] Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc, Canc Hosp, Dept Med Oncol,Natl Canc Ctr, Beijing, Peoples R China

[3] Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc, Canc Hosp, Dept VIP Med Serv,Natl Canc Ctr, Beijing, Peoples R China

来源：

ADVANCES IN RADIATION ONCOLOGY | 2023年 / 8卷 / 04期

关键词：

CARDIAC EVENTS; RADIOTHERAPY; RISK; DISEASE; SURVEILLANCE; PNEUMONITIS; TOXICITY; EXPOSURE; THERAPY; FUTURE;

D O I：

10.1016/j.adro.2023.101213

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Cardiopulmonary toxic effects may reduce the efficacy of postoperative radiation therapy (PORT) in patients with non-small cell lung cancer (NSCLC). However, few studies have examined whether the heart and lung doses affect overall survival (OS). We investigated the correlation of heart and lung doses with OS in patients with NSCLC undergoing PORT.Methods and Materials: This retrospective analysis included 307 patients with NSCLC undergoing PORT. The total dose was 50 Gy. Landmark analyses were performed at 36 months, with hazard ratios (HRs) calculated separately for events occurring up to 36 months (early survival) and after 36 months (long-term survival). Stabilized inverse probability of treatment weighting (sIPTW) was performed to balance the characteristics of the high- and low-dose groups. We performed sensitivity analyses at 24 and 48 months.Results: The median follow-up period was 67.42 months. Heart doses were significantly correlated with long-term survival (HR, 1.14; P = .015) but not with early survival (HR, 0.97; P = .41) or whole survival (HR, 1.02; P = .58). Lung doses were marginally significantly correlated with early survival (HR, 1.03; P = .07) but not with long-term survival (HR, 1.00; P = .85) or whole survival (HR, 1.02; P = .12). Higher heart and lung doses were associated with decreased long-term and early survival, respectively, before and after sIPTW. Landmark analyses at 24 and 48 months showed consistent results. Conclusions: For patients with NSCLC undergoing PORT, a higher heart dose was associated with decreased long-term survival, whereas a higher lung dose was associated with decreased early survival.& COPY; 2023 The Author(s). Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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