Clinical Outcomes and Prognostic Factors of Salvage Stereotactic Body Radiotherapy for Post-Surgical Thoracic Oligo-Recurrence/Metastasis of Non-Small-Cell Lung Cancer

Abstract

Purpose The study aimed to assess the efficacy and safety of stereotactic body radiotherapy (SBRT) using CyberKnife (CK) in patients with postoperative thoracic oligo-recurrence/metastasis of non-small-cell lung cancer (NLCLC), and to analyze the prognostic factors affecting overall survival after SBRT. Patients and Methods A total of 44 patients with postoperative thoracic oligo-recurrence/metastatic of NLCLC treated with SBRT were reviewed. Thoracic oligo-recurrence/was defined as 1–3 loco-regional confined to lung lobe, hilar/mediastinal lymph nodes, bronchial stump, or chest wall. Primary endpoints included local control (LC), overall survival (OS), progression-free survival (PFS) and toxicity. Prognostic factors that affected these patients were analyzed by the univariate and multivariate analysis by Kaplan–Meier methods and Cox regression models, respectively. Results The median follow-up time after salvage SBRT was 48.5 months. Measuring from the date of salvage SBRT, the median OS of the 44 patients was 52.60 (95% CI: 29.59–75.60) months. 1-,3-and 5-year OS rates were 97.7%, 65.3% and 47.7%, respectively. The 1-,3-year and 5-year LC rates were 97.7%, 85.1% and 80.1%, respectively. At 1, 3 and 5 years, the PFS rates were 77.1%, 28.8% and 5.3%, respectively. Multivariate analysis demonstrated that pre-SBRT neutrophil-to-lymphocyte ratio (NLR) and Charlson comorbidity index (CCI) were independent prognostic factors (p < 0.05). The treatment-related side-effects were well tolerated. No patients developed grade 3 or greater pulmonary toxicity. Conclusion SBRT is a promising salvage therapeutic option for postoperative thoracic oligo-recurrence/metastasis of non-small-cell lung cancer with acceptable toxicity. Low pre-SBRT neutrophil-to-lymphocyte ratio (NLR) and low Charlson comorbidity index (CCI) were associated with a better prognosis and longer survival and might be considered as reliable and independent prognostic factors in these patients treated with SBRT.

Construction and Validation of a Recurrent Risk Nomogram Model for Non-Small Cell Lung Cancer within 1 Year after Radical Resection

“…Therefore, early diagnosis and treatment of NSCLC should be strengthened to reduce the possibility of postoperative recurrence. Some researchers studied the related factors of recurrence and metastasis in patients with NSCLC after minimally invasive resection and found that stages II and III were common independent risk factors for recurrence and metastasis in patients with NSCLC after minimally invasive resection, similar to the results of this study [ 13 ]. Lymph node metastasis was the most important mode of lung tumor metastasis, which meant tumor cell proliferation and growth in patients.…”

Synthesis, Biological Activity, and Molecular Modelling Studies of Naphthoquinone Derivatives as Promising Anticancer Candidates Targeting COX-2

“… The synthetic pathway to generate naphthoquinone derivatives 9 – 16. Compounds 9 – 16 are synthesized from the corresponding aromatic amines and 2,3-dichloronaphthoquinone [ 1 , 4 , 19 , 20 , 21 ]. By using aryl urea in this reaction instead of an aromatic amine, we hoped to form an oxazole ring, but we failed to form 2-chloro-3-(phenylamino)-1,4-naphthoquinones 9 – 15 or 2-(4-hydroxyphenylamino)-1,4-naphthoquinone 16 .…”

“…Cigarette smoking and exposure to various environmental pollutants results in rapidly rising cases of NSCLC worldwide [ 1 , 2 ]. Approximately 60–70% of all patients with NSCLC present with late and advanced stages of the disease involving multiple organ systems [ 2 , 3 , 4 ]. Patients with advanced-stage NSCLC are generally treated with aggressive surgery, chemotherapy, radiation, or a combination of these treatments [ 2 , 3 , 4 ].…”

“…Approximately 60–70% of all patients with NSCLC present with late and advanced stages of the disease involving multiple organ systems [ 2 , 3 , 4 ]. Patients with advanced-stage NSCLC are generally treated with aggressive surgery, chemotherapy, radiation, or a combination of these treatments [ 2 , 3 , 4 ]. Despite aggressive treatment, the five-year survival rates among patients with late-stage NSCLC remain poor [ 2 , 5 ].…”

“…Numerous therapeutic options targeting NSCLC have been recently developed [ 2 , 3 , 4 , 5 ]. Classical chemotherapy drugs, such as cisplatin, doxorubicin, and paclitaxel, are often used for the treatment and control of lung cancer [ 6 , 7 , 8 , 9 ].…”