术前循环肿瘤DNA检测可预测早期非小细胞肺癌高剂量质子治疗后的复发。
Detection of pretreatment circulating tumor DNA predicts recurrence after high-dose proton beam therapy for early-stage non-small cell lung cancer.
发表日期：2023 Feb 21
作者：
Masaki Nakamura, Shun-Ichiro Kageyama, Hidenari Hirata, Taku Tochinai, Hidehiro Hojo, Atsushi Motegi, Akinori Kanai, Yutaka Suzuki, Katsuya Tsuchihara, Tetsuo Akimoto
来源：
Int J Radiat Oncol
摘要：
循环肿瘤DNA（ctDNA）被研究作为一种快速和非侵入性的生物标志物，用于预测癌症治疗效果。然而，目前对于非小细胞肺癌（NSCLC）接受放疗患者用于前治疗ctDNA的有用性的发布数据是有限的，尤其是在接受质子束放疗的患者中。本研究涉及接受质子束治疗的cT1-2N0M0非鳞状NSCLC患者。前治疗血浆和相配白细胞样本被用于靶向测序。对有或无ctDNA检测的患者的肿瘤复发率和预后进行了统计评估。在本研究中分析了43例非鳞状NSCLC患者。前治疗ctDNA可检测出43例患者中的8例（18.6％）。在幸存患者的中位随访时间为59个月（范围为15-97个月）中，可检测到的ctDNA与进展自由生存（HR，5.2；95％ CI，1.9-14.6；P<0.01）和总生存（HR，4.7；95％ CI，1.1-20.6；P=0.02）有关。根据ctDNA检测状态，在区内复发的累计发生率没有显著差异（P=0.92），但ctDNA阳性组的区外复发累计发生率显着高于ctDNA阴性组（P<0.01）。这些结果表明，前治疗ctDNA检测可以预测接受高剂量质子束治疗的cT1-2N0M0非鳞状NSCLC患者的区外复发。版权所有 © 2023 Elsevier Inc. 发布。
Circulating tumor DNA (ctDNA) has been studied as a rapid and noninvasive biomarker for predicting cancer treatment outcomes. However, published data on the usefulness of pretreatment ctDNA in patients with non-small cell lung cancer (NSCLC) who underwent radiotherapy are currently limited, especially in patients who received proton beam therapy.This study included patients with cT1-2N0M0 nonsquamous NSCLC treated with proton beam therapy. Pretreatment plasma and matched white blood cell samples were subjected to targeted sequencing. The incidence of tumor recurrence and prognosis of patients with and without ctDNA detection were statistically evaluated.Forty-three patients with nonsquamous NSCLC were analyzed in this study. Pretreatment ctDNA was detectable in 8 of 43 patients (18.6%). At the median follow-up of 59 months (range, 15-97 months) in the surviving patients, detectable ctDNA was associated with inferior progression-free survival (HR, 5.2; 95% CI, 1.9-14.6; P <0.01) and overall survival (HR, 4.7; 95% CI, 1.1-20.6; P=0.02). There was no significant difference in the cumulative incidence of in-field recurrence according to the ctDNA detection status (P=0.92), but the ctDNA-positive group showed a significantly higher cumulative incidence of out-of-field recurrence (P<0.01) than the ctDNA-negative group.These results suggest that pretreatment ctDNA detection can predict out-of-field recurrence in patients with cT1-2N0M0 nonsquamous NSCLC treated with high-dose proton beam therapy.Copyright © 2023. Published by Elsevier Inc.