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首页> 外文期刊>Journal of Clinical Medicine Research >Palliative Thoracic Radiotherapy for Lung Cancer: What Is the Impact of Total Radiation Dose on Survival?
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Palliative Thoracic Radiotherapy for Lung Cancer: What Is the Impact of Total Radiation Dose on Survival?

机译：肺癌姑息胸腔放疗：总辐射剂量对生存有何影响？

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Background: Effective symptom palliation can be achieved with low-dose palliative thoracic radiotherapy. In several studies, median survival was not improved with higher doses of radiation. More controversy exists regarding the impact of higher doses on 1- and 2-year survival rates. Therefore, a comparison of survival outcomes after radiotherapy with different biologically equivalent doses (equivalent dose in 2-Gy fractions, EQD2) was performed.Methods: This was a retrospective single-institution study of 232 patients with small or non-small cell lung cancer. Most commonly 2 fractions of 8.5 Gy were prescribed (34%), followed by 10 fractions of 3 Gy or equivalent regimens (30%, EQD2 circa 33 Gy). The highest EQD2 consisted of 45 Gy. Intention-to-treat analyses were performed.Results: Survival was significantly shorter with regimens of intended EQD2 < 33 Gy, e.g., 2 fractions of 8.5 Gy (median 2.5 months compared to 5.0 and 7.5 months with EQD2 of circa 33 and 45 Gy, respectively). The 2-year survival rates were 0%, 7% and 11%, respectively. In 128 prognostically favorable patients, median survival was comparable for the three different dose levels (6 - 8.3 months). The 2-year survival rates were 0%, 10%, and 13%, respectively (not statistically significant).Conclusion: Although most of the observed survival differences diminished after exclusion of poor prognosis patients with reduced performance status and/or progressive extrathoracic disease, a slight increase in 2-year survival rates with higher EQD2 cannot be excluded. Because of relatively small improvements, a confirmatory randomized trial in this subgroup would have to include a large number of patients.J Clin Med Res. 2017;9(6):482-487doi: https://doi.org/10.14740/jocmr2980w
机译：背景：低剂量姑息性胸腔放疗可有效缓解症状。在一些研究中，较高剂量的放射线不能改善中位生存期。关于更高剂量对1年和2年生存率的影响存在更多争议。因此，比较了不同生物学等效剂量（2-Gy等效剂量，EQD2）放疗后的生存结果。方法：这是一项回顾性单机构研究，对232例小细胞或非小细胞肺癌患者进行了回顾性研究。 。最常见的是开出2个8.5 Gy的分数（34％），然后是10个3 Gy或等效方案的分数（30％，EQD2约33 Gy）。最高的EQD2为45 Gy。结果：预期EQD2 <33 Gy的方案的生存期明显缩短，例如2份8.5 Gy（中位数为2.5个月，而EQD2分别为33和45 Gy，分别为5.0和7.5个月，分别）。 2年生存率分别为0％，7％和11％。在128位预后良好的患者中，三种不同剂量水平（6-8.3个月）的中位生存期相当。结论：尽管排除了预后不良，体力状态降低和/或进行性胸外疾病的患者，但大多数观察到的生存差异有所减少，但2年生存率分别为0％，10％和13％（无统计学意义）。 ，不能排除EQD2较高的2年生存率略有增加。由于相对较小的改善，在该亚组中进行的一项验证性随机试验将不得不包括大量患者。 2017; 9（6）：482-487doi：https://doi.org/10.14740/jocmr2980w

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