Stereotactic Body Radiotherapy for Large (> 5 cm) Non-Small-Cell Lung Cancer
Stereotactic Body Radiotherapy for Large (> 5 cm) Non-Small-Cell Lung Cancer
复制标题
DOI：
10.1016/j.cllc.2016.11.020
复制
发表时间：
2017-07-01
影响因子：
3.6
通讯作者：
Kubicek, Gregory J.
中科院分区：
文献类型：
--
作者：
Peterson, Justin;Niles, Christian;Kubicek, Gregory J.
本研究旨在更好地了解立体定向全身放射治疗 (SBRT) 治疗最大肿瘤尺寸 > 5 cm 的不可手术的非小细胞肺癌。对前瞻性 SBRT 登记处进行了回顾性分析，对 41 名患者进行了分析。 SBRT 在较大的肺部肿瘤中具有良好的局部控制和可接受的远程控制率以及治疗引起的毒性。背景：立体定向全身放射治疗 (SBRT) 是治疗 < 5 cm 早期非小细胞肺癌 (NSCLC) 肿瘤的成熟治疗选择。关于大于 5 厘米的肿瘤的信息有限。患者和方法：我们对参加前瞻性 SBRT 登记研究的患者进行了回顾性数据收集。符合本研究条件的患者患有淋巴结阴性 NSCLC，任何尺寸均大于 5 厘米。分析了 41 名患者的数据。患者中位年龄为 75 岁，肿瘤大小中位为 5.6 厘米（范围：5.0-12.2 厘米）。鳞癌16例，腺癌20例，混合瘤1例； 4例患者未进行活检。每次分次的中位辐射剂量为 5 次，共 50 Gy。放射治疗按照等剂量线进行，中位数为 66%（范围为 50%-84%）。结果：在 SBRT 之前，6 名患者接受过化疗，7 名患者接受过放疗。所有患者的中位随访时间为 15.2 个月（范围：0.56-48.1 个月）。最后一次随访时，16 名患者仍存活，存活患者的中位随访时间为 16.1 个月。中位生存期为 17.5 个月，1 年和 2 年生存率为 65% 和 34%。 2 名患者（4.8%）出现局部失败，13 名患者（31%）出现远处失败。 4 名患者（9.8%）出现急性毒性，7 名患者（17.1%）出现迟发毒性，其中 2 名患者（4.8%）出现 3 级迟发毒性。结论：SBRT对于>5cm的肿瘤是有效的，具有良好的局部控制率和可接受的毒性。主要的失败模式是遥远的，表明全身化疗在这些患者中可能发挥作用。 (C) 2016 年作者。由爱思唯尔公司出版
This study was undertaken to provide a better understanding of stereotactic body radiotherapy (SBRT) in nonoperable non-small-cell lung cancer with a largest tumor dimension of > 5 cm. A retrospective analysis was conducted on a prospective SBRT registry, with analysis of 41 patients. SBRT results in good local control and acceptable rates of distant control and treatment-induced toxicities in larger lung tumors.Background: Stereotactic body radiotherapy (SBRT) is a well-established treatment option for early stage non-small-cell lung cancer (NSCLC) tumors < 5 cm. There is limited information on tumors > 5 cm. Patients and Methods: We performed retrospective data collection of patients enrolled onto a prospective SBRT registry study. Eligible patients for this study had node-negative NSCLC measuring > 5 cm in any dimension. Data from 41 patients were analyzed. Median patient age was 75 years, and median tumor size was 5.6 cm (range, 5.0-12.2 cm). Sixteen patients had squamous disease, 20 patients adenocarcinoma, and 1 mixed tumor; 4 patients had no biopsy. Median radiation dose per fraction was 50 Gy in 5 fractions. Radiation was prescribed to isodose line, median 66% (range, 50%-84%). Results: Before SBRT, 6 patients had previous chemotherapy and 7 patients had previous radiation. Median follow-up for all patients was 15.2 months (range, 0.56-48.1 months). At last follow-up, 16 patients were still alive, with a median follow-up of 16.1 months for surviving patients. The median survival was 17.5 months with 1- and 2-year survivals of 65% and 34%. Two patients (4.8%) had local failure, and 13 patients (31%) had distant failure. Four patients (9.8%) had acute toxicity, and 7 patients (17.1%) had late toxicity, including 2 (4.8%) grade 3 late toxicities. Conclusion: SBRT for tumors > 5 cm is effective, with good local control rates and acceptable toxicity. The main pattern of failure is distant, suggesting a possible role for systemic chemotherapy in these patients. (C) 2016 The Authors. Published by Elsevier Inc.