Safety and Efficacy of Stereotactic Body Radiotherapy for Stage I Non-Small-Cell Lung Cancer in Routine Clinical Practice: A Patterns-of-Care and Outcome Analysis
Safety and Efficacy of Stereotactic Body Radiotherapy for Stage I Non-Small-Cell Lung Cancer in Routine Clinical Practice: A Patterns-of-Care and Outcome Analysis
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DOI：
10.1097/jto.0b013e318293dc45
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发表时间：
2013-08-01
影响因子：
20.4
通讯作者：
Andratschke, Nicolaus
中科院分区：
文献类型：
--
作者：
Guckenberger, Matthias;Allgaeuer, Michael;Andratschke, Nicolaus
引言：为了评估安全性和有效性的立体定向体部放疗（SBRT）为I期非小细胞肺癌（NSCLC）的护理模式和模式的outcomeanalysis.Methods：工作组颅外立体定向放射治疗的德国放射肿瘤学会进行了回顾性多中心分析的实践和结果后SBRT为I期NSCLC。16个德国和奥地利中心的经验，在肺SBRT.Results：582例患者在13个机构在1998年和2011年之间接受治疗的数据被要求participation.Results：收集所有机构，除了一个，是学术医院。观察到更先进的放射治疗技术和逐步增加的辐射剂量的时间趋势，但患者特征（年龄、体力状态、肺功能）随时间保持稳定。机构间变异性在所有治疗特征中均很大，但在患者特征中不存在。平均随访21个月后，3年无局部进展（FFLP）和总生存率（OS）分别为79.6%和47.1%。生物学有效剂量是影响FFLP和OS的最重要因素：以生物学有效剂量大于106戈伊作为计划靶区剂量（N = 164）后，3年FFLP和OS分别为92.5%和62.2%。没有观察到学习曲线或随着更丰富的SBRT经验和新放疗技术的实施而改善结果的证据。结论：尽管存在相当大的机构间差异和时间趋势，但在这种多机构、学术环境中，SBRT治疗I期非小细胞肺癌是安全有效的。SBRT实践。放疗剂量被确定为影响局部肿瘤控制和OS的主要治疗因素。
Introduction:To evaluate safety and efficacy of stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer (NSCLC) in a patterns-of-care and patterns-of-outcome analysis.Methods:The working group Extracranial Stereotactic Radiotherapy of the German Society for Radiation Oncology performed a retrospective multicenter analysis of practice and outcome after SBRT for stage I NSCLC. Sixteen German and Austrian centers with experience in pulmonary SBRT were asked to participate.Results:Data of 582 patients treated at 13 institutions between 1998 and 2011 were collected; all institutions, except one, were academic hospitals. A time trend to more advanced radiotherapy technologies and escalated irradiation doses was observed, but patient characteristics (age, performance status, pulmonary function) remained stable over time. Interinstitutional variability was substantial in all treatment characteristics but not in patient characteristics. After an average follow-up of 21 months, 3-year freedom from local progression (FFLP) and overall survival (OS) were 79.6% and 47.1%, respectively. The biological effective dose was the most significant factor influencing FFLP and OS: after more than 106 Gy biological effective dose as planning target volume encompassing dose (N = 164), 3-year FFLP and OS were 92.5% and 62.2%, respectively. No evidence of a learning curve or improvement of results with larger SBRT experience and implementation of new radiotherapy technologies was observed.Conclusion:SBRT for stage I NSCLC was safe and effective in this multi-institutional, academic environment, despite considerable interinstitutional variability and time trends in SBRT practice. Radiotherapy dose was identified as a major treatment factor influencing local tumor control and OS.