Lung Metastases Treated with Image-guided Stereotactic Body Radiation Therapy
Lung Metastases Treated with Image-guided Stereotactic Body Radiation Therapy
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DOI：
10.1016/j.clon.2012.12.005
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发表时间：
2013-04-01
影响因子：
3.4
通讯作者：
Grills, I. S.
中科院分区：
文献类型：
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作者：
Baschnagel, A. M.;Mangona, V. S.;Grills, I. S.
目的：为了评估治疗后的结果与图像引导立体定向体部放射治疗（SBRT），每天使用在线锥形束计算机断层扫描恶性肿瘤转移到lung.Materials和方法：47肺转移瘤32例进行了体积引导SBRT。中位年龄为62岁（21-87岁）。原发肿瘤包括结直肠癌（n = 10）、肉瘤（n = 4）、头颈部癌（n = 4）、黑色素瘤（n = 3）、膀胱癌（n = 2）、非小细胞肺癌（n = 2）、肾细胞癌（n = 2）、胸腺瘤（n = 2）、甲状腺癌（n = 1）、子宫内膜癌（n = 1）和食管癌（n = 1）。每例患者的肺转移灶数量范围为1 - 3个（68%为单病灶）。SBRT处方为靶体积边缘，中位剂量为60戈伊（48-65戈伊），中位剂量为4次（4 - 10次）。大部分病灶的治疗剂量为12戈伊~ 48或60戈伊（92%）。结果：中位随访时间为27.6个月（7.6-57.1个月）。所有治疗病灶的1、2和3年精算局部控制率分别为97%、92%和85%。2例原发性结直肠癌患者（共4处病变）局部失败。中位总生存期为40个月。SBRT完成后的1、2和3年总生存率分别为83%、76%和63%。无4级或5级毒性。3级毒性（各1例）包括肺炎，呼吸困难，咳嗽，肋骨骨折和pain.Conclusion：SBRT与每日在线锥束CT肺转移瘤取得了良好的局部肿瘤控制，低毒性和令人鼓舞的2年和3年生存。(C)2013年皇家放射科医师学院。由爱思唯尔有限公司出版。保留所有权利。
Aims: To evaluate outcomes after treatment with image-guided stereotactic body radiation therapy (SBRT) using daily online cone beam computed tomography for malignancies metastatic to the lung.Materials and methods: Forty-seven lung metastases in 32 patients were treated with volumetrically guided SBRT. The median age was 62 years (21-87). Primaries included colorectal (n = 10), sarcoma (n = 4), head and neck (n = 4), melanoma (n = 3), bladder (n = 2), non-small cell lung cancer (n = 2), renal cell (n = 2), thymoma (n = 2), thyroid (n = 1), endometrial (n = 1) and oesophageal (n = 1). The number of lung metastases per patient ranged from one to three (68% single lesions). SBRT was prescribed to the edge of the target volume to a median dose of 60 Gy (48-65 Gy) in a median of four fractions (four to 10). Most lesions were treated using 12 Gy fractions (92%) to 48 or 60 Gy.Results: The median follow-up was 27.6 months (7.6-57.1 months). The 1, 2 and 3 year actuarial local control rates for all treated lesions were 97, 92 and 85%, respectively. Two patients with colorectal primaries (four lesions in total) had local failure. The median overall survival was 40 months. The 1, 2 and 3 year overall survival from the time of SBRT completion was 83, 76 and 63%, respectively. There were no grade 4 or 5 toxicities. Grade 3 toxicities (one instance of each) included pneumonitis, dyspnoea, cough, rib fracture and pain.Conclusion: SBRT with daily online cone beam computed tomography for lung metastases achieved excellent local tumour control with low toxicity and encouraging 2 and 3 year survival. (C) 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.