Stereotactic, single-dose irradiation of stage I non-small cell lung cancer and lung metastases.
Stereotactic, single-dose irradiation of stage I non-small cell lung cancer and lung metastases.
复制标题
I期非小细胞肺癌和肺转移的立体定向，单剂量照射。
DOI：
10.1186/1748-717x-1-30
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发表时间：
2006-08-20
影响因子：
3.6
通讯作者：
Stoelben, Erich
中科院分区：
文献类型：
--
作者：
Fritz, Peter;Kraus, Hans-Joerg;Muehlnickel, Werner;Hammer, Udo;Doelken, Wolfram;Engel-Riedel, Walburga;Chemaissani, Assad;Stoelben, Erich
我们前瞻性地回顾了非分步立体定向高单剂量放射治疗肺肿瘤后的有效率、局部控制和副作用。58例患者接受了单剂量放射手术。在25例患者中，31例肺转移灶接受放射治疗；33例I期非小细胞肺癌（NSCLC）患者均接受放射治疗。等中心规定的标准剂量为30 Gy，轴向安全裕度为10 mm，纵向安全裕度为15 mm。计划目标体积（PTV）是通过参考呼吸阶段的三次CT扫描来定义的，这样临床目标体积（CTV）的运动范围就被封闭了。转移灶体积（CTV）为2.8 ~ 55.8 cm3（中位数：6.0 cm3）， PTV为12.2 ~ 184.0 cm3（中位数：45.0 cm3）。转移灶最大直径为0.7 ~ 4.5 cm。支气管癌体积为4.2 ~ 125.4 cm3（中位数：17.5 cm3）， PTV为15.6 ~ 387.3 cm3（中位数：99.8 cm3）。支气管癌最大直径为1.7 ~ 10cm。随访时间从6.8个月到63个月不等（中位：转移22个月，非小细胞肺癌18个月）。94%的NSCLC和87%的转移灶获得了局部控制。未观察到严重的症状性副作用。根据Kaplan-Meier法，肺转移患者的总生存率为：1年：97%，2年：73%，3年：42%，4年：42%，5年：42%（中位生存期：26个月）；NSCLC患者：1年：83%，2年：63%，3年：53%，4年：39%（中位生存期：20.4个月）。肺转移瘤或小的外周支气管癌的非分次单剂量照射是一种有效和安全的局部治疗形式，可能成为侵入性技术的可行替代方案。
We prospectively reviewed response rates, local control, and side effects after non-fractionated stereotactic high single-dose body radiation therapy for lung tumors. Fifty-eight patients underwent radiosurgery involving single-dose irradiation. With 25 patients, 31 metastases in the lungs were irradiated; with each of 33 patients, stage I non-small cell lung cancer (NSCLC) was subject to irradiation. The standard dose prescribed to the isocenter was 30 Gy with an axial safety margin of 10 mm and a longitudinal safety margin of 15 mm. The planning target volume (PTV) was defined using three CT scans with reference to the phases of respiration so that the movement span of the clinical target volume (CTV) was enclosed. The volume of the metastases (CTV) varied from 2.8 to 55.8 cm3 (median: 6.0 cm3) and the PTV varied from 12.2 to 184.0 cm3 (median: 45.0 cm3). The metastases ranged from 0.7 to 4.5 cm in largest diameter. The volume of the bronchial carcinomas varied from 4.2 to 125.4 cm3(median: 17.5 cm3) and the PTV from 15.6 to 387.3 cm3 (median: 99.8 cm3). The bronchial carcinomas ranged from 1.7 to 10 cm in largest diameter. Follow-up periods varied from 6.8 to 63 months (median: 22 months for metastases and 18 months for NSCLC). Local control was achieved with 94% of NSCLC and 87% of metastases. No serious symptomatic side effects were observed. According to the Kaplan-Meier method the overall survival probability rates of patients with lung metastases were as follows: 1 year: 97%, 2 years: 73%, 3 years: 42%, 4 years: 42%, 5 years: 42% (median survival: 26 months); of those with NSCLC: 1 year: 83%, 2 years: 63%, 3 years: 53%, 4 years: 39%: (median survival: 20.4 months). Non-fractionated single-dose irradiation of metastases in the lungs or of small, peripheral bronchial carcinomas is an effective and safe form of local treatment and might become a viable alternative to invasive techniques.