胸部CT特征对克唑替尼治疗晚期非小细胞肺癌疗效及预后的预测价值

目的:探究治疗前胸部CT特征对克唑替尼(crizotinib)治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者疗效及预后的预测价值。方法:分析2014年1月至2017年3月经克唑替尼治疗的晚期NSCLC患者47例的临床资料。对其临床资料及治疗前胸部CT图像进行分析,根据实体瘤疗效评价标准(RECIST)1.1对治疗效果进行随访评价,并记录无进展生存期(progres?sion-free survival,PFS)。结果:所有患者的中位PFS为10个月。胸部CT特征与克唑替尼疗效无相关性(P>0.05)。单因素生存分析显示,肿瘤较大(P=0.009)、中央型(P=0.002)、存在实变(P=0.002)、存在胸腔积液(P=0.001)或存在癌性淋巴管炎(P=0.019)提示患者PFS较短。Cox多因素回归分析显示,病变位置(HR=3.219,95%CI:1.517~6.833;P=0.002)为独立预后预测因素。结论:晚期NSCLC治疗前胸部CT特征对预测克唑替尼治疗预后具有一定的价值。

Prognostic value of CT characteristics in crizotinib-treated patients with advanced non-small cell lung cancer

  Objective  To investigate the prognostic value of chest computed tomography (CT) characteristics in crizotinib-treated patients with advanced non-small cell lung cancer (NSCLC).  Methods  Forty-seven patients with advanced ALK-rearranged NSCLC who received crizotinib treatment from January 2014 to March 2017 were enrolled in this retrospective study. Pre-treatment CT characteristics were evaluated. Patients were followed up after crizotinib treatment, and the best overall response and progression-free survival (PFS) were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1).  Results  The median PFS of all patients was 10 months. There was no association between CT characteristics and response. In univariate analysis, large tumor size (P= 0.009), central type (P=0.002), consolidation of surrounding lung tissue (P=0.002), pleural effusion (P=0.001), and lymphangitic carcinomatosis (P=0.019) suggested a poor prognosis. Multivariate Cox regression analysis showed that location (hazard ratio, 3.219; 95% confidence interval: 1.517-6.833; P=0.002) was an independent prognostic predictor.  Conclusions  Pre-treatment CT characteristics are useful in predicting the PFS of crizotinib-treated patients with advanced NSCLC harboring ALK rearrangement.