title: The survival outcomes and prognosis of stage IV non-small-cell lung cancer treated with thoracic three-dimensional radiotherapy combined with chemotherapy.
abstract: BACKGROUND
  The impact of thoracic three-dimensional radiotherapy on the prognosis for stage IV non-small-cell lung cancer is unclear. This study is to investigate survival outcomes and prognosis in patients with stage IV non-small cell lung cancer (NSCLC) treated with thoracic three-dimensional radiotherapy and systemic chemotherapy.
  
  
  METHODS
  Ninety three patients with stage IV NSCLC had received at least four cycles of chemotherapy and thoracic three-dimensional radiotherapy of ≥40 Gy on primary tumors. The data from these patients were retrospectively analyzed.
  
  
  RESULTS
  Of the 93 patients, the median survival time (MST) was 14.0 months, and the 1, 2, and 3-year survival rates were 54.8%, 20.4%, and 12.9%, respectively. The MST of patients received radiation dose to primary tumor ≥63Gy and <63 Gy for primary tumor were 15.0 and 8.0 months, respectively (P = 0.001). Patients had metastasis to a single site and lower tumor volume (<170 cm(3)) also produced longer overall survival time (P = 0.002, P = 0.020, respectively). For patients with metastasis at a single site, thoracic radiation dose ≥63 Gy remained a prognostic factor for better overall survival (P = 0.030); patients with metastases at multiple sites, radiation dose ≥63 Gy had a trend to improve overall survival (P = 0.062). A multivariate analysis showed that radiation dose ≥63 Gy (P = 0.017) and metastasis to a single site (P = 0.038) are associated with better overall survival, and the volume of primary tumor was marginally correlated with OS (P = 0.054).
  
  
  CONCLUSIONS
  In combination with systemic chemotherapy, radiation dose ≥63 Gy on primary tumor and metastasis to a single site are significant factors for better OS, aggressive thoracic radiotherapy may have an important role in improving OS.
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. sushengfa2005@163.com.
authors.forename: ShengFa
authors.initials: S
authors.lastname: Su
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. hyx_wengan@163.com.
authors.forename: YinXiang
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. ouyangww103173@163.com.
authors.forename: WeiWei
authors.initials: W
authors.lastname: Ouyang
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. 995388305@qq.com.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. lbgymaaaa@sohu.com.|Department of Thoracic Oncology, Gui zhou Cancer Hospital, 1 Beijing Road West, Guiyang, 550004, People's Republic of China. lbgymaaaa@sohu.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Lu
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. liqs1979@126.com.
authors.forename: QingSong
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. lihuiqin1971@sina.com.
authors.forename: HuiQin
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. ssf2010@sina.cn.
authors.forename: ZhiYong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College; and Guizhou Cancer Hospital, Guizhou, People's Republic of China. zwy8284@sina.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies