Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation
Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation
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DOI：
10.21873/anticanres.15748
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发表时间：
2022-05-01
影响因子：
2
通讯作者：
Yamada, Kei
中科院分区：
文献类型：
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作者：
Watanabe, Shou;Yamazaki, Hideya;Yamada, Kei
背景/目的：使用重复立体定向体部放疗（SBRT）的证据有限。我们研究了重复SBRT的疗效和肺毒性的预测因素。患者和方法：我们回顾了20例（27个病灶）原发性或转移性肺癌患者，他们接受了CyberKnife（R）重复SBRT。我们根据2.0-戈伊剂量的等效剂量（α/β =3）生成了剂量测定分析的复合计划。检查了2级+放射性肺炎（RP）的预测因子。结果：中位随访时间为18.0个月。1年和2年局部控制率均为95.2%。5例患者（25%）发生2级+ RP，包括5级RP。2级+ RP组表现出较高的复合平均肺剂量（MLD）和较低的5-20戈伊（VS 5-VS 20）备用肺体积。结论：使用射波刀（R）重复SBRT显示出良好的局部控制，但2级+ RP的发生率较高。累积的MLD和VS 5-VS 20可以预测RP。
Background/Aim: Evidence on the use of repeated stereotactic body radiotherapy (SBRT) is limited. We investigated the efficacy of repeated SBRT and predictors of lung toxicity. Patients and Methods: We reviewed 20 patients (27 lesions) with primary or metastatic lung cancer who underwent repeated SBRT with CyberKnife (R). We generated a composite plan for dosimetric analysis based on equivalent doses in 2.0-Gy fractions (alpha/beta=3). Predictors of Grade 2+ radiation pneumonitis ( RP) were examined. Results: The median follow-up duration was 18.0 months. The 1-year and 2-year local control were both 95.2%. Five patients ( 25%) developed Grade 2+ RP, including a Grade 5 RP. The Grade 2+ RP group showed higher composite mean lung dose (MLD) and lower lung volumes spared from 5-20 Gy (VS5-VS20). Conclusion: Repeated SBRT with CyberKnife (R) showed favorable local control, but a high rate of Grade 2+ RP. Accumulated MLD and VS5-VS20 may predict RP.