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重离子放疗对Ⅰ期非小细胞肺癌患者肺功能的影响。

Effect of heavy-ion radiotherapy on pulmonary function in stage I non-small cell lung cancer patients.

作者信息

Kadono Kennosuke, Homma Toshiaki, Kamahara Kazuyuki, Nakayama Mika, Satoh Hiroaki, Sekizawa Kiyohisa, Miyamoto Tadaaki

机构信息

Division of Respiratory Disease, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba-city, Ibaraki 305-8575, Japan.

出版信息

Chest. 2002 Dec;122(6):1925-32. doi: 10.1378/chest.122.6.1925.

Abstract

STUDY OBJECTIVES

The purpose of this study was to investigate the effect of heavy-ion radiotherapy on pulmonary function in patients with clinical stage I non-small cell lung cancer (NSCLC) patients.

DESIGN

Retrospective study.

SETTING

Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.

PATIENTS

From a total of 81 patients who were not candidates for surgical resection due to medical reasons or patient refusal, and who were treated with carbon beam radiotherapy from October 1994 to February 1999, the 52 patients who had completed the repeat overall pulmonary function tests at 6 and 12 months after undergoing heavy-ion radiotherapy were examined. The total heavy-ion irradiation dose ranged from 59.4 to 95.4 photon gray equivalents (GyE), with a mean dose of 76.2 GyE. INTERVENTIONS AND MEASUREMENT: Pulmonary function was evaluated prior to heavy-ion radiotherapy and at 6 and 12 months after heavy-ion radiotherapy. Comparisons of all pulmonary function indexes between, before, and at 6 and 12 months after heavy-ion radiotherapy were made using repeated-measures analysis of variance using the Dunnett test for post hoc comparison.

RESULTS

A statistically significant decrease in FEV(1) and total lung capacity was detected at both 6 and 12 months after the patient had undergone heavy-ion radiotherapy. No significant decreases in other pulmonary function indexes in patients were observed at either 6 or 12 months after heavy-ion radiotherapy. The magnitude of the decrease in all pulmonary function indexes was < 8% at both 6 and 12 months after heavy-ion radiotherapy.

CONCLUSIONS

These findings suggest that heavy-ion radiotherapy is feasible for stage I NSCLC patients without a severe loss of pulmonary function.

摘要

研究目的

本研究旨在调查重离子放疗对临床I期非小细胞肺癌(NSCLC)患者肺功能的影响。

设计

回顾性研究。

地点

日本千叶县国立放射科学研究所带电粒子治疗研究中心医院。

患者

从1994年10月至1999年2月因医学原因或患者拒绝而不适合手术切除且接受碳离子放疗的81例患者中,选取52例在接受重离子放疗后6个月和12个月完成重复全肺功能测试的患者进行检查。重离子总照射剂量范围为59.4至95.4光子灰度当量(GyE),平均剂量为76.2 GyE。干预措施与测量:在重离子放疗前以及放疗后6个月和12个月评估肺功能。使用重复测量方差分析及Dunnett检验进行事后比较,对重离子放疗前、放疗后6个月和12个月的所有肺功能指标进行比较。

结果

在患者接受重离子放疗后的6个月和12个月均检测到第一秒用力呼气容积(FEV(1))和肺总量有统计学意义的下降。在重离子放疗后的6个月或12个月,未观察到患者其他肺功能指标有显著下降。在重离子放疗后的6个月和12个月,所有肺功能指标的下降幅度均<8%。

结论

这些发现表明,重离子放疗对于I期NSCLC患者是可行的,且不会导致严重的肺功能丧失。

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