DOSE-RESPONSE FOR STEREOTACTIC BODY RADIOTHERAPY IN EARLY-STAGE NON-SMALL-CELL LUNG CANCER
DOSE-RESPONSE FOR STEREOTACTIC BODY RADIOTHERAPY IN EARLY-STAGE NON-SMALL-CELL LUNG CANCER
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DOI：
10.1016/j.ijrobp.2011.01.038
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发表时间：
2011-11-15
影响因子：
7
通讯作者：
Bradley, Jeffrey D.
中科院分区：
文献类型：
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作者：
Olsen, Jeffrey R.;Robinson, Clifford G.;Bradley, Jeffrey D.
目的：比较三个肺立体定向体放射治疗（SBRT）方案在一个大的institutional coherent.Methods的疗效：2004年至2009年，130例患者进行了明确的肺癌SBRT到一个单一的病变在Mallinckrodt放射学研究所。我们对周围肿瘤（n = 111）给予18戈伊x 3次，对中心或接近关键结构的肿瘤给予9戈伊x 5次（n = 8）或10戈伊x 5次（n = 11）。采用考克斯比例风险模型进行单变量和多变量预后因素分析。结果：9戈伊× 5，10戈伊× 5和18戈伊× 3组的中位随访时间分别为11，16和13个月。第1年和第2年的当地对照统计数据分别为：9戈伊x 5为75%和50%，10戈伊x 5为100%和100%，18戈伊x 3为99%和91%。9戈伊x 5、10戈伊x 5和18戈伊x 3治疗的中位总生存期分别为14个月、未达到和34个月。在对数秩检验中，10戈伊x 5和18戈伊x 3组的局部控制或总生存率无差异，但与9戈伊x 5组相比，两组的局部控制和总生存率均有所改善。在多变量分析中，9戈伊x 5的治疗是局部控制减少的唯一独立预后因素，年龄增加、肿瘤体积增加和体能状态差独立预测总生存率降低。10戈伊x 5和18戈伊x 3的治疗方案似乎对肺癌SBRT有效，并且与9戈伊x 3的治疗方案相比，提供了上级的局部控制和总生存率。5. (C)2011 Elsevier Inc.
Purpose: To compare the efficacy of three lung stereotactic body radiotherapy (SBRT) regimens in a large institutional cohort.Methods: Between 2004 and 2009, 130 patients underwent definitive lung cancer SBRT to a single lesion at the Mallinckrodt Institute of Radiology. We delivered 18 Gy x 3 fractions for peripheral tumors (n = 111) and either 9 Gy x 5 fractions (n = 8) or 10 Gy x 5 fractions (n = 11) for tumors that were central or near critical structures. Univariate and multivariate analysis of prognostic factors was performed using the Cox proportional hazard model.Results: Median follow-up was 11, 16, and 13 months for the 9 Gy x 5, 10 Gy x 5, and 18 Gy x 3 groups, respectively. Local control statistics for Years 1 and 2 were, respectively, 75% and 50% for 9 Gy x 5, 100% and 100% for 10 Gy x 5, and 99% and 91% for 18 Gy x 3. Median overall survival was 14 months, not reached, and 34 months for the 9 Gy x 5, 10 Gy x 5, and 18 Gy x 3 treatments, respectively. No difference in local control or overall survival was found between the 10 Gy x 5 and 18 Gy x 3 groups on log-rank test, but both groups had improved local control and overall survival compared with 9 Gy x 5. Treatment with 9 Gy x 5 was the only independent prognostic factor for reduced local control on multivariate analysis, and increasing age, increasing tumor volume, and poor performance status predicted independently for reduced overall survival.Conclusion: Treatment regimens of 10 Gy x 5 and 18 Gy x 3 seem to be efficacious for lung cancer SBRT and provide superior local control and overall survival compared with 9 Gy x 5. (C) 2011 Elsevier Inc.