Stereotactic body radiotherapy for T3 and T4N0M0 non-small cell lung cancer.
Stereotactic body radiotherapy for T3 and T4N0M0 non-small cell lung cancer.
复制标题
DOI：
10.1093/jrr/rrw023
复制
发表时间：
2016-06
影响因子：
2
通讯作者：
Shigematsu N
中科院分区：
文献类型：
--
作者：
Eriguchi T;Takeda A;Sanuki N;Nishimura S;Takagawa Y;Enomoto T;Saeki N;Yashiro K;Mizuno T;Aoki Y;Oku Y;Yokosuka T;Shigematsu N
为评价立体定向体部放疗（SBRT）治疗cT 3和cT 4 N 0 M0非小细胞肺癌（NSCLC）的结局和可行性，分析了2005年5月至2013年7月期间接受SBRT的25例诊断为cT 3或cT 4 N 0 M0的局限性原发性NSCLC患者。所有患者均患有不可手术的肿瘤。肿瘤不能切除的主要原因是呼吸功能不足，无法根治性切除，高龄（>80岁）或由于侵入关键器官而无法手术。患者的中位年龄为79岁（范围：60-86岁）。中位随访时间为25个月（范围：5-100个月）。T3和T4的2年总生存率分别为57%和69%。T3和T4的2年局部控制率分别为91%和68%。至于毒性，0-1级、2级和3级放射性肺炎分别发生在23、1和1例患者中。未报告其他急性或症状性晚期毒性。13例SBRT后1年无局部、纵隔或肺内进展的患者接受了肺功能检查。SBRT前和SBRT后1秒用力呼气量（FEV 1）值的中位变异为-0.1（-0.8-0.8）。该变化无统计学显著性（P = 0.56）。用力肺活量（FVC）、肺活量（VC）、%VC和%FEV1也无显著差异。SBRT治疗cT 3和cT 4 N 0 M0 NSCLC有效且可行。考虑到良好的生存率和低发病率，SBRT是cT 3和cT 4 N 0 M0 NSCLC的潜在治疗选择。
To evaluate the outcomes and feasibility of stereotactic body radiotherapy (SBRT) for cT3 and cT4N0M0 non–small cell lung cancer (NSCLC), 25 patients with localized primary NSCLC diagnosed as cT3 or cT4N0M0, given SBRT between May 2005 and July 2013, were analyzed. All patients had inoperable tumors. The major reasons for tumors being unresectable were insufficient respiratory function for curative resection, advanced age (>80 years old) or technically inoperable due to invasion into critical organs. The median patient age was 79 years (range; 60–86). The median follow-up duration was 25 months (range: 5–100 months). The 2-year overall survival rates for T3 and T4 were 57% and 69%, respectively. The 2-year local control rates for T3 and T4 were 91% and 68%, respectively. As for toxicities, Grade 0–1, Grade 2 and Grade 3 radiation pneumonitis occurred in 23, 1 and 1 patient, respectively. No other acute or symptomatic late toxicities were reported. Thirteen patients who had no local, mediastinal or intrapulmonary progression at one year after SBRT underwent pulmonary function testing. The median variation in pre-SBRT and post-SBRT forced expiratory volume in 1 s (FEV1) values was –0.1 (–0.8–0.8). This variation was not statistically significant (P = 0.56). Forced vital capacity (FVC), vital capacity (VC), %VC and %FEV1 also showed no significant differences. SBRT for cT3 and cT4N0M0 NSCLC was both effective and feasible. Considering the favorable survival and low morbidity rate, SBRT is a potential treatment option for cT3 and cT4N0M0 NSCLC.