Clinical observation: patients with centrally located early lung cancer treated by stereotactic radiotherapy
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摘要:
目的 探讨立体定向放射治疗早期中央型肺癌的临床疗效及不良反应。 方法 回顾性分析2006年11月至2010年12月立体定向放射治疗的17例分期为T1/T2N0M0的中央型非小细胞肺癌患者, 根据肿瘤位置及分期, 给予不同的分割剂量, 中位处方剂量56(48~60)Gy, 中位分割次数5(3~10)次, 中位治疗体积46.2(13.8~92.2)mL。 结果 治疗后3个月疗效评价: 9例病变完全缓解, 7例部分缓解, 1例稳定, 治疗反应率94.1%;中位随访期19.5(4~64)个月, 中位生存时间43个月, 1、2年局控率、无进展生存、总生存分别为100%、87.5%, 80.8%、67.3%和82.4%、68.4%。随访期内见呼吸困难、疲劳、肺不张等不良反应, 其中3级不良反应1例, 未见4~5级不良反应。 结论 根据肿瘤位置及分期不同, 给予不同的剂量分割模式, 立体定向放疗可以较好的应用于早期中央型肺癌的治疗。 Abstract:Objective This study investigates the clinical efficacy and toxicity of centrally located early lung cancer treated by stereotactic radiotherapy. Methods We retrospectively reviewed 17 patients with centrally located non-small cell lung cancer staged T1/ T2N0M0from November 2006 to December 2010.The differences in the position and stage of tumors were considered.Different segmentations were performed in the lesions.The median prescription dose was 56 Gy(range: 48 Gy to 60 Gy), which was delivered into five fractions(range: 3 fractions to 10 fractions).The median planning target volume was 46.2 mL(range: 13.8 mL to 92.2 mL). Results Nine patients achieved complete response, seven patients achieved partial response, and one patient achieved stable disease three months after treatment.The treatment response rate was 94.1% with a median follow-up of 19.5 months(range: 4 months to 64 months) and median survival time of 43 months.The local control, progress free survival and overall survival rates of patients at one and two years were 100% and 87.5%, 80.8% and 67.3%, and 77.3% and 53.3%, respectively.In the follow-up period, toxicities related to treatment, such as dyspnea, fatigue, and atelectasis, were observed.One patient developed Grade 3 toxicity, whereas no patient developed Grades 4 to 5 toxicities. Conclusion On the basis of the position and stage of tumors, centrally located lung cancer can be safely and effectively treated by stereotactic radiotherapy with different segmentations. -
表 1 17例中央型非小细胞肺癌患者临床资料
Table 1. Clinical data of 17 patients with centrally located lung cancer
表 2 不同分期及部位肿瘤的处方剂量
Table 2. Prescription doses for the tumor with different stages and locations
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