Pilot Study of the Safety and Efficacy of Dose Escalation in Stereotactic Body Radiotherapy for Peripheral Lung Tumors
Pilot Study of the Safety and Efficacy of Dose Escalation in Stereotactic Body Radiotherapy for Peripheral Lung Tumors
复制标题
DOI：
10.1016/j.cllc.2017.11.008
复制
发表时间：
2018-05-01
影响因子：
3.6
通讯作者：
Mizowaki, Takashi
中科院分区：
文献类型：
--
作者：
Mitsuyoshi, Takamasa;Matsuo, Yukinori;Mizowaki, Takashi
本初步研究评价了采用立体定向体部放疗治疗周围型肺肿瘤的剂量递增方法（具有陡峭剂量梯度）的安全性和有效性。1年内发生2级或2级以上放射性肺炎的比例接近10%。这种剂量递增的方法是安全和有效的外周肺肿瘤，并可能获得良好的局部控制rates.Background：这项试点研究的目的是评估的安全性和有效性的剂量递增的方法用于治疗外周肺肿瘤的管理陡峭的剂量梯度通过立体定向体放射治疗（SBRT）的目标体积。患者和方法：周围型肺肿瘤患者入组本研究，并在靶等中心分4次使用总剂量为70戈伊的SBRT进行治疗，以70%的等剂量覆盖计划靶体积表面。主要终点是1年内2级或以上放射性肺炎（RP）的发生率。结果：2014年9月至2016年1月期间，共有35例患者入组本研究。32例原发性肺癌和3例肺转移患者接受SBRT治疗。1年内4例患者观察到2级RP。随访期间未观察到重度RP（3级或以上）。中位随访期为21.2个月（范围：4.2-31.7个月）。在一例肺转移患者中观察到局部复发。32例原发性肺癌患者在随访期间未观察到局部复发。2年局部控制率和总生存率分别为95.7%（95%置信区间，72.9-99.4）和85.2%（95%置信区间，67.8-93.6）。结论：SBRT治疗周围型肺肿瘤的剂量递增方法在亚急性期是安全的。这些结果也表明，该方法可以获得良好的局部控制率。(C)2017爱思唯尔公司All rights reserved.
This pilot study evaluated the safety and efficacy of a dose escalation method with steep dose gradients using stereotactic body radiotherapy for peripheral lung tumors. The rate of grade 2 or higher radiation pneumonitis within 1 year was almost 10%. This dose escalation method was safe and effective for peripheral lung tumors and may obtain excellent local control rates.Background: This pilot study aimed to evaluate the safety and efficacy of a dose escalation method for the treatment of peripheral lung tumors by administrating steep dose gradients in the target volumes via stereotactic body radiotherapy (SBRT). Patients and Methods: Patients with peripheral lung tumors were enrolled onto this study and treated with SBRT using a total dose of 70 Gy in 4 fractions at target isocenter, covering the planning target volume surface with 70% of the isodose. The primary end point was the rate of grade 2 or higher radiation pneumonitis (RP) within 1 year. Results: A total of 35 patients were enrolled onto this study between September 2014 and January 2016. Thirty-two patients with primary lung cancers and 3 patients with lung metastases were treated with SBRT. Grade 2 RP was observed in 4 patients within 1 year. No severe RP (grade 3 or higher) was observed within the follow-up period. The median follow-up period was 21.2 months (range, 4.2-31.7 months). Local recurrence was observed in a single patient with lung metastasis. No local recurrence was observed within the follow-up period in the 32 patients with primary lung cancer. The local control and overall survival rates at 2 years were 95.7% (95% confidence interval, 72.9-99.4) and 85.2% (95% confidence interval, 67.8-93.6), respectively. Conclusion: This dose escalation method with steep dose gradients using SBRT for peripheral lung tumors was safe in the subacute phases. These results also suggest that this method can obtain excellent local control rates. (C) 2017 Elsevier Inc. All rights reserved.