Abstract：
BACKGROUND: Stereotactic body radiation therapy (SBRT) is a treatment for patients with early-stage non-small cell lung cancer (ES-NSCLC). Surveillance guidelines vary after treatment. While patients are more likely to locally recur within 2 years of treatment, there remains a paucity of data on the benefit of frequent and long-term surveillance. We evaluated a cohort of NSCLC patients to evaluate surveillance patterns and outcomes.
METHODS: Patients with ES-NSCLC treated with SBRT were retrospectively evaluated. Imaging was reviewed after SBRT for evidence of recurrence or new malignancy. The median scan interval (MSI) was calculated as the median number of months between surveillance scans. The MSI between patients with or without new disease was compared by t-test. New disease development and survival between patients with=T2 disease and with or without prior malignancy was compared using χ², Kaplan-Meier analysis, and Gray\'s test.
RESULTS: A cohort of 168 patients with median follow up of 23.4 months met criteria for review with 50% developing new disease. MSI did not differ between patients with or without new disease. Patients with >=cT2 tumors had worse overall survival and trended towards higher incidence of new disease. New disease continued to occur, even 5 years after treatment.
CONCLUSIONS: Increased scan frequency did not increase detection of new disease. Patients continued to fail 5 years after treatment. Larger tumors trended toward more frequent failures and those patients experienced worse OS. Surveillance guidelines should be optimized to prevent over surveillance after treatment and to continue long-term surveillance.
METHODS: Patients with ES-NSCLC treated with SBRT were retrospectively evaluated. Imaging was reviewed after SBRT for evidence of recurrence or new malignancy. The median scan interval (MSI) was calculated as the median number of months between surveillance scans. The MSI between patients with or without new disease was compared by t-test. New disease development and survival between patients with
RESULTS: A cohort of 168 patients with median follow up of 23.4 months met criteria for review with 50% developing new disease. MSI did not differ between patients with or without new disease. Patients with >=cT2 tumors had worse overall survival and trended towards higher incidence of new disease. New disease continued to occur, even 5 years after treatment.
CONCLUSIONS: Increased scan frequency did not increase detection of new disease. Patients continued to fail 5 years after treatment. Larger tumors trended toward more frequent failures and those patients experienced worse OS. Surveillance guidelines should be optimized to prevent over surveillance after treatment and to continue long-term surveillance.
摘要：
背景：立体定向放射治疗（SBRT）是早期非小细胞肺癌（ES-NSCLC）患者的一种治疗方法。监测指南在治疗后有所不同。虽然患者在治疗后2年内更有可能局部复发，关于频繁和长期监测的益处的数据仍然很少。我们评估了一组NSCLC患者，以评估监测模式和结果。
方法：回顾性评估接受SBRT治疗的ES-NSCLC患者。SBRT后进行影像学检查，以了解复发或新的恶性肿瘤的证据。中位扫描间隔（MSI）计算为监测扫描之间的中位月数。通过t检验比较有或没有新疾病的患者之间的MSI。使用χ²比较患有=T2疾病的患者与有或没有先前恶性肿瘤的患者之间的新疾病发展和生存率，Kaplan-Meier分析,和格雷的测试。
结果：一组168例患者，中位随访时间为23.4个月，符合审查标准，其中50%为新发疾病。有或没有新疾病的患者之间的MSI没有差异。>=cT2肿瘤的患者总体生存率较差，并且有新疾病发生率较高的趋势。新的疾病继续发生，甚至在治疗后5年。
结论：增加扫描频率并没有增加对新疾病的检测。患者在治疗后5年持续失败。较大的肿瘤倾向于更频繁的失败，这些患者的OS较差。应优化监测指南，以防止治疗后过度监测并继续长期监测。
方法：回顾性评估接受SBRT治疗的ES-NSCLC患者。SBRT后进行影像学检查，以了解复发或新的恶性肿瘤的证据。中位扫描间隔（MSI）计算为监测扫描之间的中位月数。通过t检验比较有或没有新疾病的患者之间的MSI。使用χ²比较患有
结果：一组168例患者，中位随访时间为23.4个月，符合审查标准，其中50%为新发疾病。有或没有新疾病的患者之间的MSI没有差异。>=cT2肿瘤的患者总体生存率较差，并且有新疾病发生率较高的趋势。新的疾病继续发生，甚至在治疗后5年。
结论：增加扫描频率并没有增加对新疾病的检测。患者在治疗后5年持续失败。较大的肿瘤倾向于更频繁的失败，这些患者的OS较差。应优化监测指南，以防止治疗后过度监测并继续长期监测。
