The clinical study of chest radiotherapy and optimal timing of intervention in oligometastatic stage IV NSCLC

Objective To clarify the significance of chest radiotherapy in the treatment of oligometastatic stage ⅠV non-small cell lung cancer (NSCLC) and to explore the optimal time of interventional therapy during chest radiotherapy. Methods A total of 192 patients with oligometastatic stage ⅠV NSCLC admitted to Shanxi Provincial Cancer Hospital from 2008 to 2014 were randomly and evenly divided into the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups. Survival analysis was performed with Kanplan-Meier method. Results The median survival of 192 patients with oligometastatic stage ⅠV NSCLC was 14.50 months, and the 1-, 2-and 3-year survival rates were 57.4%, 24.0% and 10.7%, respectively. The median survivalin the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups was 10, 21, 18 and 13 months, respectively. The 1-year survival rates were 34%, 73%, 71% and 51%, 10%, 40%, 32% and 13% for the 2-year survival rates, and 0%, 24%, 16% and 3% for the 3-year survival rates (P=0.000). The median survival of patients with radiotherapy dose ≥ 60 Gy and< 60 Gy was 21 and 13 months, 76% and 53% for the 1-year survival rates, 34% and 21% for the 2-year survival rates, and 17% and 10% for the 3-year survival rates (P=0.002). Conclusion Early interventional therapy and high-dose radiotherapy can improve the local control rate and prolong the survival time of patients with oligometastatic stage ⅠV NSCLC. Key words: Lung neoplasm/radiotherapy; Oligometastasis; Intervention timing; Prognosis