在一项随机试验中，比较了两种局限期小细胞肺癌老年患者每天两次胸部放疗方案的的治疗结果

SCI 15 February 2023

Treatment outcomes of older participants in a randomized trial comparing two schedules of twice-daily thoracic radiotherapy in limited stage small-cell lung cancer

（Journal of Thoracic Oncology; IF：20.121）

Killingberg KT, Grønberg BH, Slaaen M, Kirkevold Ø, Halvorsen TO, Treatment outcomes of older participants in a randomized trial comparing two schedules of twice-daily thoracic radiotherapy in limited stage small-cell lung cancer, Journal of Thoracic Oncology (2023), doi:https://doi.org/10.1016/j.jtho.2023.01.012.

Corresponding author:

Kristin Toftaker Killingberg

Department of Cancer Research and Molecular medicine

NTNU, Norwegian University of Science and Technology

PO Box 8905, 7491 Trondheim, Norway

Introduction 介绍  

Half of patients with limited stage small cell lung cancer (LS SCLC) are >70 years, but account for <20% of participants in most trials. Comorbidities, reduced organ- and physical function might lead to more treatment toxicity and population-based studies indicate that fewer older than younger LS SCLC patients receive standard chemoradiotherapy, although there is limited evidence for such a policy.

局限性小细胞肺癌(LS SCLC)患者中有一半为70岁，但在大多数试验中占参与者的比例<20%。合并症、器官和身体功能降低可能导致更多的治疗毒性，基于人群的研究表明，接受标准放化疗的LS SCLC患者中，年龄较大的患者少于年龄较小的患者，尽管这一政策的证据有限。

Methods 方法  

We compared baseline characteristics, comorbidity, survival, treatment completion, toxicity, health related quality of life (HRQoL) and treatment outcomes between patients >70 and <70 years in an open label randomized phase II trial comparing twice-daily thoracic radiotherapy (TRT) of 45 Gy in 30 fractions with 60 Gy in 40 fractions in LS SCLC. All patients received concurrent platinum/etoposide chemotherapy.

在一项开放标签随机II期试验中，我们比较了年龄在70岁和<70岁之间的患者的基线特征、共病、生存期、治疗完成度、毒性、健康相关生活质量(HRQoL)和治疗结果，比较了LS SCLC患者每天两次胸部放射治疗(TRT) 45 Gy (30次)和60 Gy (40次)。所有患者均同时接受铂/依托泊苷化疗。

Results 结果  

170 patients who were >18 years and had performance status (PS) 0-2 were randomized. Of these, 53 patients (60 Gy:25, 45 Gy:28) were >70 years and 117 (60 Gy:64, 45 Gy:53) were younger. There were no significant differences in baseline characteristics, treatment completion rates, toxicity, or response rates across age groups. HRQoL mean scores was similar during year one, but older patients reported more decline on functional scales than younger patients during year two. OS was significantly shorter for older patients while there was no significant difference in PFS or TTP.

170例>为18岁且表现状态(PS)为0-2的患者被随机分组。其中53例(60 Gy: 25,45 Gy:28)年龄为70岁，117例(60 Gy: 64,45 Gy:53)年龄较轻。在不同年龄组的基线特征、治疗完成率、毒性或缓解率方面无显著差异。第一年的HRQoL平均分相似，但老年患者在第二年的功能量表上比年轻患者下降更多。年龄较大的患者OS明显较短，PFS、TTP无明显差异。

Conclusion 结论  

Patients >70 years tolerated concurrent twice daily chemoradiotherapy and achieved similar disease control as younger patients, indicating that older patients should receive the same treatment as younger patients.

>70岁的患者可同时接受每日两次放化疗，疾病控制与年轻患者相似，表明老年患者应接受与年轻患者相同的治疗。

打赏