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Abstract：
To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2-16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers-a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.
摘要：
评价转移性间变性淋巴瘤激酶+非小细胞肺癌患者的影像学和临床特征及克唑替尼不同行的疗效。这个国家,非干预性，多中心，回顾性档案筛查研究评估了人口学，临床,和放射成像特征，以及2013-2017年间接受治疗的患者的治疗方法。共有367名患者（54.8%为男性，包括诊断时的中位年龄54岁）。其中,45.4％是吸烟者，8.7%有肺癌家族史。关于放射学发现，55.9%的肿瘤位于外周，7.7%的患者有空洞性病变,42.9%出现胸腔积液。非吸烟者的胸腔积液高于吸烟者（37.3%vs.25.3%,P=.018）。约47.4%的病例在治疗期间发生远处转移,最常见的是大脑（26.2％）。化疗是一线治疗的55.0%。客观缓解率为61.9%（完全缓解：7.6%；部分缓解：54.2%）。在接受克唑替尼作为二线治疗的患者中观察到最高的完全和部分缓解率。中位无进展生存期为14个月（标准误差：1.4，95％置信区间：11.2-16.8个月）。克唑替尼治疗线产生相似的无进展生存期(P=.078)。最常见的治疗相关不良事件是疲劳（14.7%）。男性和吸烟者肾上腺转移明显增高，在非吸烟者中,胸膜受累和积液明显较高,这是一个以前没有报道过的新发现.放射学和组织学特征与文献数据一致，但是临床特征的一些差异可能与人群特征有关。
