孤立性肺肿瘤应用立体定向体部放射治疗的疗效分析

doi:10.3969/j.issn.1000-8535.2015.02.011

摘要/Abstract

摘要： 目的分析立体定向体部放射治疗(SBRJ)应用于孤立性肺肿瘤的疗效,探讨其临床价值。方法采用拓能(TOPSLANE)全身X线立体定向放射治疗系统治疗15例孤立性肺肿瘤患者,其中I期非小细胞肺癌患者8例,单个肺转移瘤患者7例。单次剂量为5~8Gy／次,每天1次,每周3次,共8~10次,总剂量50~64Gy,生物有效剂量(BED)75~115Gy。分析治疗的近期疗效、急性放射损伤和局部控制率。结果 3例患者完全缓解(20.0%),10例患者部分缓解(66.7%),2例患者病灶稳定(13.3%),没有疾病进展的患者。15例患者总有效率为86.7%(13/15)。BED<90Gy的患者有效率为33.3%,而BED>90Gy的患者有效率为100%,差异有统计学意义(P＜0.05)。3例患者出现2级急性放射损伤,未见3级以上毒副反应。1年和2年局控率分别为92.3%和81.2%。结论 SBRT治疗孤立性肺肿瘤可获得较好的近期疗效和局部控制率,急性放射损伤较轻。

关键词: 孤立性肺肿瘤, 立体定向体部放射治疗, 疗效

Abstract: Objective To analyze the efficacy of stereotactic body radiation therapy(SBRT) onsolitary pulmonary tumor and explore its clinical value. Methods TOPSLANE X-ray stereotactic body radiation therapy system was used for treatment of fifteen patients with solitary pulmonary tumor, including eight patients with stage I non-small cell lung cancer and seven patients with single lung metastasis. Fraction dose of 5 to 8Gy was prescribed once a day, three times a week, totally 8 to 10 times to a total dose of 50 to 64 Gy and biological effective dose(BED) of 75 to 115Gy. Short-term efficacy, acute radiation injury and local control rate were analyzed. Results After treatment, there were three patients with complete response (CR) (20.0%), ten patients with partial response (PR) (66.7%), tow patients with stable disease (SD) (13.3%), and no patients with progressive disease (PD). The total response rate was 86.7% (13/15). The response rate was 33.3% in patients with BED <90 Gy, while it was 100% in patients with BED> 90 Gy, and the difference was statistically significant (P<0.05). Grade 2 acute radiation injuries were observed in three patients, and no toxicity greater than grade 3 was observed. The 1-year and 2-year local control rate was 92.3% and 81.2%, respectively. Conclusion SBRT on solitary pulmonary tumor has good short-term efficacy and local control rate with mild acute radiation injury.

Key words: Solitary pulmonary tumor, Stereotactic body radiation therapy, Efficacy

伍勇, 曹小飞, 翁成荫, 甘庆权, 陈小君, 刘国龙. 孤立性肺肿瘤应用立体定向体部放射治疗的疗效分析[J]. 广州医药, 2015, 46(2): 32-34.

Wu Yong, Cao Xiaofei, Weng Chengyin, et al. Efficacy analysis of stereotactic body radiation therapy on solitary pulmonary tumor[J]. Guangzhou Medical Journal, 2015, 46(2): 32-34.

参考文献

[1] Ashworth A, Rodrigues G, Boldt G, et al. Is there an oligometastatic state in non-small cell lung cancer? A systematic review of the literature[J].Lung Cancer, 2013, 82 (2): 197-203.
[2] Dosoretz DE, Katin MJ, Blitzer PH, et al. Medically inoperable lung carcinoma: the role of radiation therapy[J]. Semin Radiat Oncol, 1996, 6(2):98-104.
[3] Crabtree TD, Puri V, Robinson C, et al. Analysis of first recurrence and survival in patients with stage I non-small cell lung cancer treated with surgical resection or stereotactic radiation therapy[J]. J Thorac Cardiovasc Surg, 2014, 147(4):1183-1191.
[4] National Comprehensive Cancer Network.Non-Small Cell Lung Cancer(Version 3.2014)[J/OL]. http://www. nccn. org/professionals/physician_gls/pdf/nscl.pdf
[5] Gauden S, Ramsay J, Tripcony L. The curative treatment by radiotherapy alone of stage I non-small cell carcinoma of the lung[J]. Chest, 1995, 108(5):1278-1282.
[6] Onishi H, Shirato H, Nagata Y, et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study[J]. J Thorac Oncol, 2007,2(7 Suppl 3):S94-100.
[7] Grills IS, Hope AJ, Guckenberger M, et al. A collaborative analysis of stereotactic lung radiotherapy outcomes for early-stage non-small-cell lung cancer using daily online cone-beam computed tomography image-guided radiotherapy[J]. J Thorac Oncol,2012,7(9):1382-1393.
[8] Decker RH, Tanoue LT, Colasanto JM, et al. Evaluation and definitive management of medically inoperable early-stage non-small-cell lung cancer. Part 1: Assessment and conventional radiotherapy[J]. Oncology (Williston Park), 2006, 20(7):727-736.
[9] Palma DA, Haasbeek C, Rodrigues G, et al. Stereotactic ablative radiotherapy for comprehensive treatment of oligometastatic tumors (SABR-COMET): study protocol for a randomized phase II trial[J]. BMC Cancer, 2012(12): 305.
[10] Lagerwaard FJ, Verstegen NE, Haasbeek CJ, et al. Outcomes of stereotactic ablative radiotherapy in patients with potentially operable stage I non-small cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 83(1):348-353.
[11] Filippi AR, Badellino S, Guarneri A, et al. Outcomes of single fraction stereotactic ablative radiotherapy for lung metastases[J]. Technol Cancer Res Treat, 2014, 13(1):37-45.
[12] Widder J, Klinkenberg TJ, Ubbels JF, et al. Pulmonary oligometastases: metastasectomy or stereotactic ablative radiotherapy[J]. Radiother Oncol, 2013, 107(3):409-413.

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