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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Influence of tumour laterality on patient survival in non-small cell lung cancer after radiotherapy
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Influence of tumour laterality on patient survival in non-small cell lung cancer after radiotherapy

机译：肿瘤横向性对放射治疗后非小细胞肺癌患者存活的影响

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Background: Lung cancer survival after radiotherapy remains poor and greater knowledge of normal tissue risk factors is needed to further optimise treatments. In this work, we investigate tumour laterality in a large cohort of patients treated with curative-intent radiotherapy, including the effect of dose on the right and left lungs. Methods: 1101 NSCLC patients were included in the analysis, treated with 55 Gy in 20 fractions. Tumour laterality was determined by comparing the centre of mass of the tumour volume with the centre of mass of the lung. Right and left lungs were segmented from the whole lung contour and the mean dose to each volume calculated. Laterality and mean lung doses were included in multi-variable cox-regression survival models. Results: 1026 patients were eligible for inclusion; 579 right-sided and 447 left-sided tumours were identified. All tumour and patient characteristics were balanced with laterality. The multi-variable models were controlled for known clinical factors: tumour volume (p < 0.001), age (p < 0.001), performance status (p < 0.05) and nodal stage (p < 0.01). Multi-variable analysis showed laterality to be highly significant (p < 0.01) with right-sided tumours showing worse overall survival than left-sided tumours (15 versus 18 months). The right lung mean dose was found to be significant (p = 0.03) for overall survival but the left lung mean dose was not (p = 0.78). Conclusion: Our study showed that right-sided lung tumours show worse overall survival for NSCLC treated with curative-intent radiotherapy. Results suggest that the effect of laterality is through a difference in dose-response for individual lungs, with the larger, right lung, having the greater impact on survival.
机译：背景：放疗后的肺癌存活仍然差，需要对正常组织风险因素进行更大的了解，以进一步优化治疗方法。在这项工作中，我们调查肿瘤横向性，患有疗效放疗治疗的大型患者队列，包括剂量在右侧和左肺的作用。方法：1101例NSCLC患者含有分析，用55μm的20分数处理。通过将肿瘤体积的质量中心与肺的肿块比较来确定肿瘤横向。从整个肺轮廓和左肺部分段，并计算每个体积的平均剂量。横向和平均肺剂量包括在多变量Cox-回归存活模型中。结果：1026名患者有资格包涵式;确定了579右侧和447个左侧肿瘤。所有肿瘤和患者特征都与横向平衡。控制多变量模型用于已知的临床因素：肿瘤体积（P <0.001），年龄（P <0.001），性能状态（P <0.05）和节点阶段（P <0.01）。多变量分析显示出高度显着（P <0.01），右侧肿瘤显示出比左侧肿瘤更差的整体存活率（15与18个月）。右肺平均剂量被发现是总存活的显着（p = 0.03），但左肺平均剂量不是（p = 0.78）。结论：我们的研究表明，右侧肺部肿瘤表现出用疗效放疗的NSCLC治疗的总体存活率更差。结果表明，横向性的效果是通过对个体肺的剂量反应差异，具有较大，右肺，对生存产生更大的影响。

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