Particle beam radiation therapy using carbon ions and protons for oligometastatic lung tumors.
Particle beam radiation therapy using carbon ions and protons for oligometastatic lung tumors.
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DOI：
10.1186/1748-717x-9-183
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发表时间：
2014-08-16
期刊：
影响因子：
--
通讯作者：
Fuwa N
中科院分区：
文献类型：
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作者：
Sulaiman NS;Fujii O;Demizu Y;Terashima K;Niwa Y;Akagi T;Daimon T;Murakami M;Sasaki R;Fuwa N
本研究旨在分析使用碳离子和质子的粒子束放射治疗（PBRT）治疗少转移性肺肿瘤患者的有效性和可行性。本研究共纳入了2003年至2011年期间接受PBRT治疗少转移性肺肿瘤的47例患者（59处病变）。患者中位年龄为66岁（范围：39-84岁）。原发肿瘤部位为结直肠11例（23.4%），肺10例（21.3%），其他部位26例（55.3%）。31例患者（66%）在PBRT前接受了化疗。33个病灶用320 MeV碳离子治疗，26个病灶用150或210 MeV质子在1-4个入口治疗。在等中心点分8次（范围，4-26）输送的中位总剂量为60（范围，52.8-70.2）GyE。中位随访时间为17个月。2年局部控制率、总生存率和无进展生存率分别为79%、54%和27%。观察到PBRT相关毒性; 6例患者（13%）发生2级毒性（包括2例2级放射性肺炎），6例患者（13%）发生3级毒性。单因素分析显示，生物等效剂量10（BED 10）<110 Gy E10的患者局部复发率显著较高。在以结直肠为原发肿瘤部位的患者亚组中，局部控制率相对较低。在接受BED 10 ≥ 110 GyE 10照射的结直肠癌转移灶中未观察到局部进展。质子和碳离子治疗的治疗结果没有差异。PRBT在治疗寡转移性肺肿瘤中耐受性良好且有效。为了进一步改善局部控制，BED 10 ≥ 110 GyE 10的高剂量PBRT可能是有希望的。需要进一步研究肺寡转移的PBRT。
A study was undertaken to analyze the efficacy and feasibility of particle beam radiation therapy (PBRT) using carbon ions and protons for the treatment of patients with oligometastatic lung tumors. A total of 47 patients with 59 lesions who underwent PBRT for oligometastatic lung tumors between 2003 and 2011 were included in this study. Patient median age was 66 (range, 39–84) years. The primary tumor site was the colorectum in 11 patients (23.4%), lung in 10 patients (21.3%) and a variety of other sites in 26 patients (55.3%). Thirty-one patients (66%) received chemotherapy prior to PBRT. Thirty-three lesions were treated with 320-MeV carbon ions and 26 were treated with 150- or 210-Mev protons in 1–4 portals. A median total dose of 60 (range, 52.8–70.2) GyE was delivered at the isocenter in 8 (range, 4–26) fractions. The median follow-up time was 17 months. The local control, overall survival and progression-free survival rates at 2 years were 79%, 54 and 27% respectively. PBRT-related toxicities were observed; six patients (13%) had grade 2 toxicity (including grade 2 radiation pneumonitis in 2) and six patients (13%) had grade 3 toxicity. Univariate analysis indicated that patients treated with a biologically equivalent dose of 10 (BED10) <110 GyE10, had a significantly higher local recurrence rate. Local control rates were relatively lower in the subsets of patients with the colorectum as the primary tumor site. No local progression was observed in metastases from colorectal cancer irradiated with a BED10 ≥ 110 GyE10. There was no difference in treatment results between proton and carbon ion therapy. PRBT is well tolerated and effective in the treatment of oligometastatic lung tumors. To further improve local control, high-dose PBRT with a BED10 ≥ 110 GyE10 may be promising. Further investigation of PBRT for lung oligometastases is warranted.