Hof Holger, Muenter Marc, Oetzel Dieter, Hoess Angelika, Debus Juergen, Herfarth Klaus
University of Heidelberg, Department of Radiation Oncology, Heidelberg, Germany.
Cancer. 2007 Jul 1;110(1):148-55. doi: 10.1002/cncr.22763.
The clinical results after stereotactic single-dose radiotherapy of nonsmall-cell lung cancer (NSCLC) stages I and II were evaluated.
Forty-two patients with biopsy-proven NSCLC received stereotactic radiotherapy. Patients were treated in a stereotactic body frame and breathing motion was reduced by abdominal compression. The single doses used ranged between 19 and 30 Gy/isocenter.
After a median follow-up period of 15 months (range, 1.5-72 months) the actuarial overall survival rates and disease-free survival rates were 74.5%, 65.4%, 37.4%, and 70.2%, 49.1%, 49.1% at 12, 24, and 36 months after therapy, respectively. The actuarial local tumor control rates were 89.5%, 67.9%, and 67.9% at 12, 24, and 36 months after therapy, respectively. A significant difference (P = .032) in local tumor control was found for patients receiving 26-30 Gy (n = 32) compared with doses of less than 26 Gy (n = 10). The effect of the tumor volume on local tumor control was also evaluated. Although the difference was not statistically significant (P = .078), the subgroup of tumors with a tumor volume of less than 12 cm(3) (n = 10) experienced no tumor recurrence. Thirteen (31%) patients developed metastases during follow-up, whereas isolated regional lymph node recurrence was only encountered in 2 patients. No clinically significant treatment-associated side effects were documented.
Stereotactic single-dose radiotherapy is a safe and effective treatment option for patients with early stage NSCLC not suitable for surgery. Especially for small tumor volumes it seems to be equally effective as hypofractionated radiotherapy, while minimizing the overall treatment time.
评估了I期和II期非小细胞肺癌（NSCLC）立体定向单次放疗后的临床结果。
42例经活检证实为NSCLC的患者接受了立体定向放疗。患者在立体定向体架中接受治疗，通过腹部压迫减少呼吸运动。使用的单次剂量在19至30 Gy/等中心之间。
中位随访期为15个月（范围1.5 - 72个月），治疗后12、24和36个月的精算总生存率分别为74.5%、65.4%、37.4%，无病生存率分别为70.2%、49.1%、49.1%。治疗后12、24和36个月的精算局部肿瘤控制率分别为89.5%、67.9%、67.9%。与接受低于26 Gy剂量（n = 10）的患者相比，接受26 - 30 Gy剂量（n = 32）的患者在局部肿瘤控制方面存在显著差异（P = 0.032）。还评估了肿瘤体积对局部肿瘤控制的影响。尽管差异无统计学意义（P = 0.078），但肿瘤体积小于12 cm³（n = 10）的亚组未出现肿瘤复发。13例（31%）患者在随访期间发生转移，而仅2例患者出现孤立的区域淋巴结复发。未记录到具有临床意义的与治疗相关的副作用。
立体定向单次放疗是不适合手术的早期NSCLC患者的一种安全有效的治疗选择。特别是对于小肿瘤体积，它似乎与分割放疗同样有效，同时将总治疗时间降至最低。
