Simultaneous integrated dose reduction intensity-modulated radiotherapy applied to an elective nodal area of limited-stage small-cell lung cancer.
Simultaneous integrated dose reduction intensity-modulated radiotherapy applied to an elective nodal area of limited-stage small-cell lung cancer.
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同步综合减剂量调强放疗应用于有限期小细胞肺癌选择性淋巴结区
DOI：
10.3892/etm.2015.2835
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发表时间：
2015-12
影响因子：
2.7
通讯作者：
Zhao L
中科院分区：
文献类型：
--
作者：
Liu Z;Liu W;Ji K;Wang P;Wang X;Zhao L
本研究的目的是评估同时综合减剂量调强放疗（SIR-IMRT）在有限期小细胞肺癌（LS-SCLC）患者选择性淋巴结区应用的临床疗效和毒性。2010年1月至2013年3月，回顾性分析了52例接受SIR-IMRT治疗的LS-SCLC患者。54 Gy的辐射剂量分30份（1.8 Gy/份）照射到计划靶体积（PTV）。同时，对计划总肿瘤体积按30份（2 Gy/份）给予60 Gy。根据不良事件通用术语标准（3.0版）估计辐射相关毒性。使用Kaplan-Meier方法估计总生存期（OS）、局部无复发生存期和无进展生存期。截至末次随访，中位随访时间为16.5个月，中位OS为24.0个月，21例（40.4%）患者出现治疗失败。在这些患者中，5例（9.6%）患者发生野内复发（在PTV的95%等剂量曲线内），1例（1.9%）患者发生野外复发（非远处转移）。在4/52（7.6%）患者中观察到3级或更高级别的治疗相关肺炎，2/52（3.8%）患者经历了3级放射相关食管炎。本初步研究结果表明，SIR-IMRT对LS-SCLC患者是安全有效的，应在大型前瞻性临床试验中进一步评估。
The purpose of this study was to evaluate the clinical efficacy and toxicity of simultaneous integrated dose reduction intensity-modulated radiotherapy (SIR-IMRT) applied to an elective nodal area of patients with limited-stage small-cell lung cancer (LS-SCLC). Between January 2010 and March 2013, 52 patients with LS-SCLC that was treated with SIR-IMRT were retrospectively analyzed. A radiation dose of 54 Gy was administered in 30 fractions (1.8 Gy/fraction) to the planning target volume (PTV). Simultaneously, 60 Gy was administered in 30 fractions (2 Gy/fraction) to the planning gross tumor volume. Radiation-related toxicities were estimated according to the Common Terminology Criteria for Adverse Events (version 3.0). Overall survival (OS), locoregional recurrence-free survival and progression-free survival were estimated using the Kaplan-Meier method. By the last follow-up, the median follow-up time was 16.5 months, the median OS was 24.0 months, and 21 (40.4%) patients had experienced treatment failure. Of these patients, 5 (9.6%) patients developed in-field recurrence (within the 95% isodose curve of the PTV) and 1 (1.9%) patient developed an out-of-field recurrence (not a distant metastasis). Grade 3 or higher treatment-related pneumonia was observed in 4/52 (7.6%) patients, and grade 3 radiation-related esophagitis was experienced by 2/52 (3.8%) patients. The results of this preliminary study suggest that SIR-IMRT is safe and effective for patients with LS-SCLC and should be further evaluated in a large prospective clinical trial.