論文

国際誌
2022年11月

The efficacy profiles of concurrent chemoradiotherapy with intensity-modulated radiotherapy followed by durvalumab in patients with unresectable stage III non-small cell lung cancer: A multicenter retrospective cohort study.

Clinical and translational radiation oncology
  • Yuichiro Takeda
  • Yusaku Kusaba
  • Yoko Tsukita
  • Yukari Uemura
  • Eisaku Miyauchi
  • Takaya Yamamoto
  • Hiroshi Mayahara
  • Akito Hata
  • Hidetsugu Nakayama
  • Satoshi Tanaka
  • Junji Uchida
  • Kazuhiro Usui
  • Tatsuya Toyoda
  • Motohiro Tamiya
  • Masahiro Morimoto
  • Yuko Oya
  • Takeshi Kodaira
  • Keiichi Jingu
  • Hisatoshi Sugiura
  • 全て表示

37
開始ページ
57
終了ページ
63
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.ctro.2022.08.010

Purpose: Intensity-modulated radiotherapy (IMRT) is currently used more commonly than 3-dimensional conformal radiation for definitive thoracic radiation. We examined the efficacy profiles of concurrent chemoradiotherapy (CCRT) with IMRT after durvalumab became clinically available. Methods: We reviewed the clinical records of patients with stage III non-small cell lung cancer (NSCLC) treated with CCRT and IMRT at seven centers in Japan and investigated relapse and survival from May 2018 to December 2019. The primary endpoint of this report was progression-free survival (PFS). Results: Among 107 patients enrolled in the study, 87 were sequentially administered durvalumab. From CCRT commencement, patients were followed up for a median period of 29.7 months. The median PFS at the end of the CCRT was 20.7 months. Among the 87 patients, 58 experienced disease relapses, of whom 36 (62.1 %) had distant metastases. Multivariate Cox regression analysis revealed that a favorable response to CCRT, a radiation dose ≥ 62 Gy, and stage IIIA NSCLC were associated with prolonged PFS (all P = 0.04). Multivariate logistic regression by landmark analysis revealed that mortality risk factors were durvalumab treatment duration ≤ 11.7 months, a lower maximum grade of immune-related adverse events, FEV1 < 2805 mL, and radiation dose < 62 Gy (P = 0.01, 0.01, 0.03, and 0.04, respectively). Conclusions: In patients with NSCLC receiving CCRT using IMRT, long PFS was associated with a better response to CCRT, stage IIIA NSCLC, and an increased radiation dose. The duration of durvalumab consolidation also played an essential role in the survival of patients receiving CCRT with IMRT. (250 words).

リンク情報
DOI
https://doi.org/10.1016/j.ctro.2022.08.010
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/36065360
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440238
ID情報
  • DOI : 10.1016/j.ctro.2022.08.010
  • PubMed ID : 36065360
  • PubMed Central 記事ID : PMC9440238

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