ACUTE SKIN TOXICITY FOLLOWING STEREOTACTIC BODY RADIATION THERAPY FOR STAGE I NON-SMALL-CELL LUNG CANCER: WHO'S AT RISK?
ACUTE SKIN TOXICITY FOLLOWING STEREOTACTIC BODY RADIATION THERAPY FOR STAGE I NON-SMALL-CELL LUNG CANCER: WHO'S AT RISK?
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DOI：
10.1016/j.ijrobp.2008.08.036
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发表时间：
2008-12-01
影响因子：
7
通讯作者：
Rosenzweig, Kenneth E.
中科院分区：
文献类型：
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作者：
Hoppe, Bradford S.;Laser, Benjamin;Rosenzweig, Kenneth E.
目的：我们在前瞻性管理的早期非小细胞肺癌（NSCLC）患者数据库中检查急性皮肤毒性的发生率，并研究可能预测皮肤毒性的因素。方法：从2006年5月到2008年1月，50例I期NSCLC患者在纪念斯隆-凯特琳癌症中心接受了60 Gy分3次或44-48 Gy分4次的治疗。患者接受6 MV直线加速器的多重共面光束（3-7，中位数4）治疗，采用调强放疗（IMRT）和动态多叶准直。毒性分级是根据国家癌症研究所不良反应通用术语标准进行的。2级或以上急性皮肤反应相关因素采用Fisher精确试验计算。结果：经过至少3个月的随访，19例患者（38%）出现1级急性皮肤毒性，4例患者（8%）出现2级急性皮肤毒性，2例患者（4%）出现3级急性皮肤毒性，1例患者出现4级急性皮肤毒性。与2级或以上急性皮肤毒性相关的因素包括仅使用3束（p = 0.0007），肿瘤到胸壁后皮肤的距离小于5厘米（p = 0.006），最大皮肤剂量为规定剂量的50%或更高（p = 0.02）。结论：SBRT可能与显著的皮肤毒性有关。在评估治疗方案时必须考虑皮肤剂量，并考虑固定装置的整体效果。(C) 2008爱思唯尔公司
Purpose: We examined the rate of acute skin toxicity within a prospectively managed database of patients treated for early-stage non-small-cell lung cancer (NSCLC) and investigated factors that might predict skin toxicity.Methods: From May 2006 through January 2008,50 patients with Stage I NSCLC were treated at Memorial Sloan-Kettering Cancer Center with 60 Gy in three fractions or 44-48 Gy in four fractions. Patients were treated with multiple coplanar beams (3-7, median 4) with a 6 MV linac using intensity-modulated radiotherapy (IMRT) and dynamic multileaf collimation. Toxicity grading was performed and based on the National Cancer Institute Common Terminology Criteria for Adverse Effects. Factors associated with Grade 2 or higher acute skin reactions were calculated by Fisher's exact test.Results: After a minimum 3 months of follow-up, 19 patients (38%) developed Grade 1, 4 patients (8%) Grade 2, 2 patients (4%) Grade 3, and I patient Grade 4 acute skin toxicity. Factors associated with Grade 2 or higher acute skin toxicity included using only 3 beams (p = 0.0007), distance from the tumor to the posterior chest wall skin of less than 5 cm (p = 0.006), and a maximum skin dose of 50% or higher of the prescribed dose (P = 0.02).Conclusions: SBRT can be associated with significant skin toxicity. One must consider the skin dose when evaluating the treatment plan and consider the bolus effect of immobilization devices. (C) 2008 Elsevier Inc.