内容紹介
A Retrospective Study Analyzing the Clinical Course of Patients with Non-Small Cell Lung Cancer Receiving Local or Systemic Therapy after Post-Operative Recurrence
Summary
Background: While systemic therapy is one of the therapeutic options available for post-operative recurrence of non-small cell lung cancer, efficacy of local therapy for locoregional recurrence or limited metastatic lesions has also been reported. Objective: We aimed to evaluate the clinical course of patients with post-operative recurrence(locoregional or limited metastatic lesion)after receiving local or systemic therapy. Methods: Clinical data were retrospectively analyzed and survival duration was compared using the logrank test. Results: A total of 22 patients were included. Median progression-free survival in patients receiving local therapy, systemic chemotherapy, or a combination of both therapies was 15.1 months, 6.3 months, and 13 months, respectively. Two patients receiving treatment with EGFR-TKI did not show disease progression at 41.3 months and 45.8 months(p=0.265). Median overall survivals in patients receiving local therapy, systemic chemotherapy, or a combination of both therapies were 26.5 months, 20 months, and 37.9 months, respectively(p=0.510). After the treatment, 6 patients showed regrowth of the recurrent lesion, 8 patients showed remote metastases, and 2 patients showed both regrowth of the recurrent lesion and remote metastases. Conclusion: Patients who received treatment including local therapy showed longer survival duration, but statistical significance was not detected. Our study suggested that regrowth of the recurrent lesion and remote metastases can be equally observed after treatment.
要旨
背景:非小細胞肺癌の術後再発に対しては全身化学療法が治療法としてあがるが,一方で局所または限局性遠隔転移再発例における局所治療の効果が報告されている。目的:非小細胞肺癌術後局所再発および限局性遠隔転移再発例における局所または全身治療実施後の臨床経過を評価する。方法:後方視的に診療データを解析しlogrank検定により生存期間を比較した。結果:22例を対象とした。progression free survival中央値は局所治療群15.1か月,全身治療群(殺細胞性抗癌剤)6.3か月,局所治療と全身治療(殺細胞性抗癌剤)併用群で13か月であり,分子標的治療薬群2例では41.3か月,45.8か月において無増悪であった(p=0.265)。overall survival中央値は局所治療群26.5か月,全身治療群(殺細胞性抗癌剤)20か月,局所治療と全身治療(殺細胞性抗癌剤)併用群37.9か月(p=0.510)であった。治療後の増悪は,治療標的病変の再増大6例,遠隔転移8例,両者の混在が2例に認められた。結論:局所治療を含む治療を受けた群において生存期間中央値がより長い結果が得られたが,統計学的有意差は検出されなかった。治療後の増悪は治療標的病変の再増大,遠隔転移ともに同程度に生じ得ることが示唆された。
目次
Summary
Background: While systemic therapy is one of the therapeutic options available for post-operative recurrence of non-small cell lung cancer, efficacy of local therapy for locoregional recurrence or limited metastatic lesions has also been reported. Objective: We aimed to evaluate the clinical course of patients with post-operative recurrence(locoregional or limited metastatic lesion)after receiving local or systemic therapy. Methods: Clinical data were retrospectively analyzed and survival duration was compared using the logrank test. Results: A total of 22 patients were included. Median progression-free survival in patients receiving local therapy, systemic chemotherapy, or a combination of both therapies was 15.1 months, 6.3 months, and 13 months, respectively. Two patients receiving treatment with EGFR-TKI did not show disease progression at 41.3 months and 45.8 months(p=0.265). Median overall survivals in patients receiving local therapy, systemic chemotherapy, or a combination of both therapies were 26.5 months, 20 months, and 37.9 months, respectively(p=0.510). After the treatment, 6 patients showed regrowth of the recurrent lesion, 8 patients showed remote metastases, and 2 patients showed both regrowth of the recurrent lesion and remote metastases. Conclusion: Patients who received treatment including local therapy showed longer survival duration, but statistical significance was not detected. Our study suggested that regrowth of the recurrent lesion and remote metastases can be equally observed after treatment.
要旨
背景:非小細胞肺癌の術後再発に対しては全身化学療法が治療法としてあがるが,一方で局所または限局性遠隔転移再発例における局所治療の効果が報告されている。目的:非小細胞肺癌術後局所再発および限局性遠隔転移再発例における局所または全身治療実施後の臨床経過を評価する。方法:後方視的に診療データを解析しlogrank検定により生存期間を比較した。結果:22例を対象とした。progression free survival中央値は局所治療群15.1か月,全身治療群(殺細胞性抗癌剤)6.3か月,局所治療と全身治療(殺細胞性抗癌剤)併用群で13か月であり,分子標的治療薬群2例では41.3か月,45.8か月において無増悪であった(p=0.265)。overall survival中央値は局所治療群26.5か月,全身治療群(殺細胞性抗癌剤)20か月,局所治療と全身治療(殺細胞性抗癌剤)併用群37.9か月(p=0.510)であった。治療後の増悪は,治療標的病変の再増大6例,遠隔転移8例,両者の混在が2例に認められた。結論:局所治療を含む治療を受けた群において生存期間中央値がより長い結果が得られたが,統計学的有意差は検出されなかった。治療後の増悪は治療標的病変の再増大,遠隔転移ともに同程度に生じ得ることが示唆された。