Safety and Efficacy of Lattice Radiotherapy in Voluminous Non-small Cell Lung Cancer
Safety and Efficacy of Lattice Radiotherapy in Voluminous Non-small Cell Lung Cancer
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DOI：
10.7759/cureus.4263
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发表时间：
2019-03-18
影响因子：
1.2
通讯作者：
Qureshi, Ian Z.
中科院分区：
文献类型：
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作者：
Amendola, Beatriz E.;Perez, Naipy C.;Qureshi, Ian Z.
目的点阵放射治疗（LRT）是一种向不适合手术的大体积肿瘤提供异质剂量辐射的新技术。 LRT 基于传统的二维网格构建，利用新技术的力量，三维辐射允许将更高剂量的辐射传递到大肿瘤内的小球体（也称为顶点），同时限制对周围健康组织的暴露。该研究的主要目标是评估这批大块非小细胞肺癌患者的肿瘤反应和 LRT 的总体安全性。材料和方法在七年的时间里，10 名患有大块、不可切除肿瘤的非小细胞肺癌 (NSCLC) 患者接受了单次 LRT 治疗，随后接受常规分段放射治疗。患者接受的初始 LRT 剂量为：顶点 18 Gy，周边 3 Gy。 LRT 后，所有患者继续接受常规放射治疗：每日 25 至 29 次 1.8 Gy 至 2 Gy 的剂量。结果中位随访 6 个月（范围：1 至 71 个月），肿瘤体积平均减少 42%。整个组的总生存期为 4 至 86 个月（平均 22 个月，中位数 16 个月）。没有与轻轨相关的死亡率。没有发现明显的急性或慢性毒性。结论在这个小队列中，LRT 似乎是治疗大块 NSCLC 的安全有效的方式。需要进一步的研究来确定其在治疗大量 NSCLC 中的功效。
ObjectiveLattice radiotherapy (LRT) is a novel technique of delivering heterogeneous doses of radiation to voluminous tumors not amenable to surgery. Built from the conventional two-dimensional grid, LRT utilizes the power of new technology, three-dimensional radiation allowing the delivery of higher doses of radiation to small spheres, also called vertices, inside bulky tumors while limiting exposure to surrounding healthy tissue. The main goals of the study were the evaluation of tumor response and the overall safety of LRT in this cohort of patients with bulky non-small cell lung cancer.Materials and methodsDuring a seven-year period, 10 patients with non-small cell lung cancer (NSCLC), who presented with bulky, unresectable tumors, were treated using a single fraction of LRT followed by conventionally fractionated radiation. Patients received one initial LRT fraction of 18 Gy in the vertices and 3 Gy in the periphery. After the LRT, all patients continued with conventional radiation: 25 to 29 daily fractions of 1.8 Gy to 2 Gy.ResultsWith a median follow-up of six months (range: one to 71 months), the mean decrease in tumor volume was 42%. The overall survival of the entire group ranged from four to 86 months (mean 22, median 16). There was no mortality related to LRT. No significant acute or chronic toxicity was noted.ConclusionIn this small cohort, LRT appears to be a safe and effective modality to treat bulky NSCLC. Further research is needed to establish its efficacy in the management of voluminous NSCLC.