Clinical and histopathological research on radiation therapy for early stage non-small cell lung cancer

早期非小细胞肺癌放射治疗的临床及组织病理学研究

• 批准号: 10670826
• 负责人: HAYAKAWA Kazushige
• 金额: $ 0.32万
• 依托单位: Gunma University, School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10670826/
• 关键词: Non-small cell lung cancer; Early stage disease; Radiation therapy; Brachytherapy; Stereotactic radiotherapy; p53; Apoptosis; FDG-PET; 肺癌; かん関連遺伝子; 放射線感受性; 免疫組織化学; 小線源治療

1) The effectiveness of high dose rate (HDR) endobronchial brachytherapy for roentgenographically negative carcinoma of the bronchus was prospectively evaluated. In our department, 14 lesions in 12 patients (11 male, one female) were treated with a combination of external radiotherapy and HDR endobronchial brachytherapy. Radiation dose was 40 Gy in 20 fractions for external radiotherapy. Endobronchial brachytherapy consisted of 10-25 Gy with 5 Gy/fr and the dose reference point varied 5-10 mm radius from the center of the applicator each according to a diameter of the bronchus. All patients had macroscopic complete response. Although the follow-up period ranged from 6 to 33 months with a median of 11 months, there were no patients with local progression. Radiation pneumonitis or other treatment-related complications have not been observed. These results suggested that the combination treatment of external radiotherapy and HDR brachytherapy can be used as curative intent for selected pa … More tients who have roentgenographically negative tumors limited to the bronchial wall without adjacent parenchymal extension or metastatic disease.2) The outcome of limited field irradiation for medically inoperable patients with peripheral stage I non-small cell lung cancer (NSCLC) was analyzed to discuss the elective irradiation of regional lymph nodes. There was no significant difference in disease-specific survival between ten patients with the elective regional irradiation and 26 patients without the regional nodal irradiation. Only one patient without regional nodal irradiation developed an isolated regional failure. High-dose limited field RT is justified for medically inoperable patients with peripheral stage I NSCLC. The regional nodal irradiation can be omitted in these pulmonary compromised patients because of the low regional relapse rate.3) The prognostic significance of nuclear p53 protein expression in survival and local control was investigated immunohistochemically in 36 patients with inoperable or unresectable non-small cell lung cancer who were treated with radiation therapy (RT). Response to RT was found in all p53 negative cases versus 72% in p53 positive cases (P<0.05). The 2-year survival rate for p53 negative cases was superior to that for p53 positive cases, although this difference was not statistically significant. The results suggested that p53 protein expression may be of predictive value on response to RT in non-small cell lung cancer.4) We designed the current prospective study to evaluate FDG PET in the detection of recurrent or residual tumors in patients who had undergone definitive radiation therapy (RT) for primary lung cancer. With a standardized uptake value (SUV) 【greater than or equal】 3 used for detecting recurrent lesion, sensitivity, specificity, and accuracy were 75%, 100%, and 89%, respectively. PET may be useful for distinguishing recurrent lesion from postradiation changes. Less

1)前瞻性评价了高剂量率（HDR）支气管腔内近距离放射治疗X线阴性支气管癌的有效性。在我科，12例患者（11例男性，1例女性）的14个病灶接受了外放疗和HDR支气管内近距离放射治疗的联合治疗。外照射剂量40戈伊，分20次。支气管内近距离放射治疗包括10-25戈伊，5戈伊/fr，剂量参考点根据支气管直径从施源器中心起5-10 mm半径变化。所有患者均达到肉眼完全缓解。虽然随访时间范围为6至33个月，中位时间为11个月，但没有患者出现局部进展。未观察到放射性肺炎或其他治疗相关并发症。这些结果表明，外照射和HDR近距离放射治疗的联合治疗可以作为治疗目的，用于选定的患者。 ...更多信息 X线阴性肿瘤局限于支气管壁而无邻近实质侵犯或转移性疾病的患者。2）分析医学上不能手术的外周I期非小细胞肺癌（NSCLC）患者有限野照射的结果，以讨论区域淋巴结的选择性照射。10例选择性区域照射患者和26例未进行区域淋巴结照射的患者之间的疾病特异性生存率无显著差异。只有一个病人没有区域淋巴结照射发展成一个孤立的区域失败。高剂量限制野RT对于医学上无法手术的外周I期NSCLC患者是合理的。对36例不能手术或不能手术切除的非小细胞肺癌患者行放射治疗（RT），通过免疫组化方法研究了核内p53蛋白表达对生存和局部控制的预后意义。p53阴性者RT反应率为72%，p53阳性者RT反应率为72%，两者比较差异有显著性（P<0.05）。p53阴性病例的2年生存率上级优于p53阳性病例，但差异无统计学意义。结果提示，p53蛋白表达可能对非小细胞肺癌放疗的疗效有预测价值。4）我们设计了当前的前瞻性研究，以评估FDG PET在检测原发性肺癌患者接受确定性放疗（RT）后复发或残留肿瘤中的作用。标准化摄取值（SUV）[大于或等于] 3用于检测复发病灶，敏感性，特异性和准确性分别为75%，100%和89%。PET可用于鉴别复发病灶和放射后改变。少

项目成果

Hayakawa, K., Mitsuhashi, N., Niibe, H., et al.: "Limited field irradiation for medically inoperable patients with peripheral stage I non-small cell lung cancer."Lung Cancer. 26(3). 137-142 (1999)

Hayakawa, K.、Mitsuhashi, N.、Niibe, H.等人：“对患有 I 期外周非小细胞肺癌的无法手术的患者进行有限的野照射。”肺癌。

Sakurai, H., Mitsuhashi, N., Hayakawa, K., Niibe, H., et al.: "Interaction between low dose-rate irradiation, mild hyperthermia and low-dose caffeine in a human lung cancer cell line."Int J Radiat Biol. 75(6). 739-745 (1999)

Sakurai, H.、Mitsuhashi, N.、Hayakawa, K.、Niibe, H.等人：“人肺癌细胞系中低剂量率照射、温和热疗和低剂量咖啡因之间的相互作用。”Int

Hayakawa, K., Mitsuhashi, N., Niibe, H., et al.: "Radiation therapy for elderly patients with limited non-small cell lung cancer" J Jpn Soc Ther Radiol Oncol. 10(3). 223-228 (1998)

Hayakawa, K.、Mitsuhashi, N.、Niibe, H.等人：“局限性非小细胞肺癌老年患者的放射治疗”J Jpn Soc Ther Radiol Oncol。

Suzuki Y.: "In vivo study of radiosensitizing effect of hypoxic cell radiosensitizer PR-350 on a human SCLC"Anticancer Res.. 19(5B). 3993-4000 (1999)

Suzuki Y.：“缺氧细胞放射增敏剂 PR-350 对人类 SCLC 放射增敏作用的体内研究”Anticancer Res.. 19(5B)。

Hayakawa,K.: "Comparison of effects of doxorubicin and radiation on p53-dependent apoptosis in vivo"Oncology Report. 7. 267-270 (2000)

Hayakawa, K.：“阿霉素和辐射对体内 p53 依赖性细胞凋亡的影响比较”肿瘤学报告。