Clinical outcomes of CyberKnife stereotactic body radiotherapy for peripheral stage I non-small cell lung cancer
Clinical outcomes of CyberKnife stereotactic body radiotherapy for peripheral stage I non-small cell lung cancer
复制标题
DOI：
10.1007/s12032-015-0506-1
复制
发表时间：
2015-03-01
期刊：
影响因子：
3.4
通讯作者：
Zhu, Xi-Xu
中科院分区：
文献类型：
--
作者：
Shen, Ze-Tian;Wu, Xin-Hu;Zhu, Xi-Xu
本研究的目的是评价CyberKnife立体定向全身放疗(SBRT)治疗I期非小细胞肺癌(NSCLC)的临床疗效。50例拒绝手术或内科无法手术的周围型I期非小细胞肺癌患者，分3次接受48~60GY(中位剂量：57GY)治疗。86%的患者进行了组织病理学检查。30例患者为T1肿瘤，20例患者为T2肿瘤。超过95%的靶体积被72%的等剂量表面覆盖。在所有患者的肿瘤内或肿瘤附近植入基准点，以跟踪肿瘤的运动和呼吸模式。中位随访时间35个月(3~45个月)。根据CT扫描，40例患者完全缓解，6例部分缓解，2例病情稳定，2例病情进展。局部控制率(CR+PR)为92%，2年疾病控制率(CR+PR+SD)为96%。全组1年总存活率为86%，2年总存活率为74%。2名患者(4%)在放置标记物后出现III级毒性。5名患者(10%)发生了与治疗相关的晚期III级毒性。没有观察到大于III级的毒性。对于不能手术的I期非小细胞肺癌患者，CyberKnife SBRT实现了高的局部控制率和长期疗效，并具有可接受的毒性。然而，长期随访是必要的，以评估存活率和晚期毒性。
The aim of this study was to evaluate the clinical outcome of CyberKnife stereotactic body radiotherapy (SBRT) for patients with stage I non-small cell lung cancer (NSCLC). Fifty patients with peripheral stage I NSCLC who refused surgery or were medically inoperable were treated with 48-60 Gy (median dose: 57 Gy) in three divided doses. Histopathology was available in 86 % of patients. Thirty patients had a T1 tumor, and 20 patients had T2 tumors. More than 95 % of the target volume was covered by the 72 % isodose surface. Fiducials were implanted in or near the tumors in all patients to track tumor movement and breathing patterns. The median follow-up time was 35 months (3-45 months). Based on computed tomography scans, 40 patients achieved complete remission, six patients achieved partial remission, two patients exhibited stable disease, and two patients had progressive disease. The local control rate (CR + PR) was 92 %, and the 2-year disease control rate (CR + PR + SD) was 96 %. Overall survival for the whole group was 86 % at 1 year and 74 % at 2 years. Grade III toxicity occurred in two patients (4 %) after marker placement. Treatment-related late grade III toxicity occurred in five patients (10 %). Toxicities greater than grade III were not observed. CyberKnife SBRT achieves a high rate of local control and long-term curative effect with acceptable toxicity for patients with inoperable stage I NSCLC. However, long-term follow-up is necessary to evaluate survival and late toxicity.