Clinical and histopathological research on radiation therapy in the multidisciplinary treatment of non-small cell lung cancer

放射治疗多学科治疗非小细胞肺癌的临床及组织病理学研究

• 批准号: 13670962
• 负责人: HAYAKAWA Kazushige
• 金额: $ 2.3万
• 依托单位: Kitasato 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: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13670962/
• 关键词: Radiation therapy; Non-small cell lung cancer; Stereotactic irradiation; Brachytherapy; Respiratory gating; late toxicity; Radiosensitivity; 密封放射線治療

1) To reduce the normal tissue damage, we have developed an apparatus using spiro analyzer to control respiratory organ motion. Using this respiratory monitoring system the reproducibility of target location in the lung at the end-expiratory phase was excellent, because the mean deviations were almost less than 1.5mm, and this apparatus can be used to reduce margin for 3D conformal irradiation.2) We performed to evaluate the clinical outcomes of three dimensional (3D) conformal single high-dose boost radiosurgery (SRS) for peripheral T1 NSCLC using this system. Nineteen patients with peripheral stage 1 NSCLC were treated in our hospital and were followed for >3 months. Fourteen patients had T1 tumors and 5 had T2 tumors. The size of T1 tumors ranged from 15 mm to 30 mm in diameter and T2 tumors were less than 45 mm in diameter. All patients were treated with a standard fractionation of 30Gy/10fractions or 40Gy/20 fractions and a single high-does boost of 20Gy using 3D non-coplanar SRS. … More C-arm linear accelerator (Mitsubishi Co. Ltd.) was used for SRS and a spiro-analyzer was adopted for gating respiratory tumor motion. Of the 19 tumors 10 tumors (53%) almost disappeared after treatment. Six tumors (32%) decreased in size by 50% or more after treatment. Therefore 16 tumors (84%) showed a local response. During the follow-up of 4-24 months (median 15), no radiation pneumonitis greater than National Cancer. Institute-Common Toxicity Criteria Grade 1 was noted except one patient had grade 2 pneumonitis.3) The effectiveness of high dose rate (HDR) endobronchial brachytherapy for roentgenographically negative carcinoma of the bronchus was prospectively evaluated. In our department, 13 lesions in 11 patients (5 patients, endobronchial early cancer) 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. The follow-up period ranged from 10 to 46 months. Although there ware two patients with local progression, no patient with early cancer had local recurrence. Radiation pneumonitis or other severe 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 patients who have roentgenographically negative tumors limited to the bronchial wall without adjacent parenchymal extension or metastatic disease. Less

1)为了减少正常组织的损伤，我们开发了一种使用Spiro分析仪来控制呼吸器官运动的装置。使用该呼吸监测系统，在呼气末阶段肺内靶定位的重复性极好，因为平均偏差几乎小于1.5mm，2）评价三维适形单次高剂量增强放射外科（SRS）的临床效果用于外周T1 NSCLC。19例外周1期NSCLC患者在我院接受治疗，并随访>3个月。T1期肿瘤14例，T2期肿瘤5例。T1肿瘤直径15 ~ 30 mm，T2肿瘤直径小于45 mm。所有患者均接受30 Gy/10次或40 Gy/20次的标准分割治疗，并使用3D非共面SRS单次高剂量增强20 Gy。 ...更多信息 C形臂直线加速器（Mitsubishi Co. Ltd.）的SRS和spiro-analyzer门控呼吸肿瘤的运动。19个肿瘤中10个（53%）治疗后肿瘤基本消失。治疗后，6个肿瘤（32%）的大小减少了50%或更多。因此，16例肿瘤（84%）显示局部缓解。随访4-24个月（中位数15个月），无大于国家癌症的放射性肺炎。除1例患者发生2级肺炎外，均为研究所通用毒性标准1级。3）前瞻性评价了高剂量率（HDR）支气管内近距离放射治疗X线阴性支气管癌的有效性。在我科，11例患者（5例，支气管内早期癌）的13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。随访时间为10 ~ 46个月。虽然有两名患者局部进展，但没有早期癌症患者局部复发。尚未观察到放射性肺炎或其他严重的治疗相关并发症。这些结果表明，联合外放疗和HDR近距离放射治疗可用于治疗选定的患者，这些患者的X线阴性肿瘤仅限于支气管壁，无邻近实质扩展或转移性疾病。少

项目成果

早川和重, 他: "小細胞癌・非小細胞癌に対するPCI(予防的全頭蓋照射)の意義"肺癌の臨床. 4・1. 93-97 (2001)

Kazushige Hayakawa 等人：“PCI（预防性全颅照射）对小细胞癌/非小细胞癌的意义”临床肺癌 4・1（2001 年）。

Sakurai H, Hayakawa K, et al.: "A challenge for non-small cell lung cancer using hyperthermia"Jpn.J.Hyperthermic Oncol.. 17・1. 23-31 (2001)

樱井 H、早川 K 等：“利用热疗对非小细胞肺癌的挑战”Jpn.J.Hyperthermic Oncol.. 17・1 (2001)。

早川 和重(分担): "大川智彦, 田中良明編, 癌・放射線療法2002"篠原出版新社. 615-628 (2002)

Kazushige Hayakawa（撰稿人）：“Tomohiko Okawa，Yoshiaki Tanaka（编辑），Cancer/Radiotherapy 2002” Shinohara Publishing Shinsha 615-628（2002）。

Sakurai H., Hayakawa K., Tamaki Y., Nakayama Y., Ishikawa H., Mitsuhashi N.: "A challenge for non-small cell lung cancer using hyperthermia"Jpn. J. Hyperthermic Oncol.. 17(1). 23-31 (2001)

Sakurai H.、Hayakawa K.、Tamaki Y.、Nakayama Y.、Ishikawa H.、Mitsuhashi N.：“利用热疗治疗非小细胞肺癌的挑战”Jpn。

Sakurai H., Hayakawa K., Mitsuhashi N., Tamaki Y., Nakayama Y., Kurosaki H., Nasu S., Ishikawa H., Saitoh J., Akimoto T., Niibe H.: "Effect of hyperthermia combined with external radiation therapy in primary non-small cell lung cancer with direct bony inv

Sakurai H.、Hayakawa K.、Mitsuhashi N.、Tamaki Y.、Nakayama Y.、Kurosaki H.、Nasu S.、Ishikawa H.、Saitoh J.、Akimoto T.、Niibe H.：“热疗与