Local Control of Metastatic Lung Tumors Treated with SBRT of 48 Gy in Four Fractions: In Comparison with Primary Lung Cancer
Local Control of Metastatic Lung Tumors Treated with SBRT of 48 Gy in Four Fractions: In Comparison with Primary Lung Cancer
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DOI：
10.1093/jjco/hyp129
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发表时间：
2010-02-01
影响因子：
2.4
通讯作者：
Uwatsu, Kotaro
中科院分区：
文献类型：
--
作者：
Hamamoto, Yasushi;Kataoka, Masaaki;Uwatsu, Kotaro
立体定向放射治疗（SBRT）治疗转移性肺肿瘤的最佳剂量尚未明确。研究了转移性肺肿瘤的局部控制率，48 Gy分四次进行SBRT治疗，这是日本I期原发性肺癌的常用剂量计划之一。2006 - 2008年间，10例患者的12个转移性肺肿瘤（结直肠癌7例，其他5例）和52例患者的56个I期原发性肺癌病变（T1, 43例；T2, 13例）在等中心接受了4次48 Gy的SBRT治疗。转移性肺肿瘤患者的两年总生存率为86%，一期原发性肺癌患者的两年总生存率为96% （P = 0.4773）。转移性肺癌1年和2年的局部控制率分别为48%和25%，一期原发性肺癌的局部控制率分别为91%和88% （P < 0.0001）。与I期原发性肺癌相比，转移性肺肿瘤经48 Gy四段SBRT后的局部控制率明显较差。在SBRT中，转移性肺肿瘤应与原发性肺癌明确区分，并应给予更高的剂量。
The optimal dose of stereotactic body radiotherapy (SBRT) for metastatic lung tumors has not been clarified. Local control rates of metastatic lung tumors treated with SBRT of 48 Gy in four fractions, which is one of the common dose schedules for Stage I primary lung cancer in Japan, were examined.Between 2006 and 2008, 12 metastatic lung tumors (colorectal cancer, 7; others, 5) in 10 patients and 56 lesions of Stage I primary lung cancer (T1, 43; T2, 13) in 52 patients were treated with SBRT of 48 Gy in four fractions at the isocenter.Two-year overall survival rates were 86% for patients with metastatic lung tumors and 96% for patients with Stage I primary lung cancer (P = 0.4773). One- and 2-year local control rates were 48% and 25% for metastatic lung tumors, and 91% and 88% for Stage I primary lung cancer, respectively (P < 0.0001).The local control rates after SBRT of 48 Gy in four fractions were significantly worse in metastatic lung tumors compared with Stage I primary lung cancer. In SBRT, metastatic lung tumors should be clearly differentiated from primary lung cancer and should be given higher doses.