Koto Masashi, Takai Yoshihiro, Ogawa Yoshihiro, Matsushita Haruo, Takeda Ken, Takahashi Chiaki, Britton Keith R, Jingu Kei-ichi, Takai Kenji, Mitsuya Masatoshi, Nemoto Kenji, Yamada Shogo
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai, Japan.
Radiother Oncol. 2007 Dec;85(3):429-34. doi: 10.1016/j.radonc.2007.10.017. Epub 2007 Nov 26.
The outcome of stage I non-small cell lung cancer (NSCLC) patients treated with conventional radiotherapy is inferior to that of patients treated surgically. We aimed to evaluate the clinical outcome of stereotactic body radiotherapy (SBRT) in the treatment of stage I NSCLC.
We performed SBRT for 31 stage I NSCLC patients. Of these, 20 were medically inoperable, and 11 refused surgery. Nineteen tumours were T1-stage masses, and 12 tumours were T2. Median tumour size was 25 mm. SBRT was administered as 45 Gy/3 fractions; however, when the tumour was close to an organ at risk, 60 Gy/8 fractions were used. These doses were prescribed at the centre of the tumours.
The median duration of observation for all patients was 32 months (range, 4-87 months). In 9 of the 31 cases, local recurrence was observed. The 3-year local control rates of T1 and T2 tumours were 77.9% and 40.0%, respectively. The 3-year overall and cause-specific survival rates were 71.7% and 83.5%, respectively. Although the symptoms improved with medical treatment, 5 patients developed acute pulmonary toxicity > or =grade 2.
SBRT is safe and effective for stage I NSCLC patients. However, a more intensive treatment regimen should be considered for T2 tumours.
接受传统放疗的I期非小细胞肺癌（NSCLC）患者的预后不如接受手术治疗的患者。我们旨在评估立体定向体部放疗（SBRT）治疗I期NSCLC的临床疗效。
我们对31例I期NSCLC患者进行了SBRT。其中，20例因医学原因无法手术，11例拒绝手术。19个肿瘤为T1期肿块，12个肿瘤为T2期。肿瘤中位大小为25mm。SBRT给予45Gy分3次照射；然而，当肿瘤靠近危及器官时，采用60Gy分8次照射。这些剂量在肿瘤中心处方。
所有患者的中位观察时间为32个月（范围4 - 87个月）。31例中有9例观察到局部复发。T1和T2肿瘤的3年局部控制率分别为77.9%和40.0%。3年总生存率和病因特异性生存率分别为71.7%和83.5%。尽管经药物治疗症状有所改善，但5例患者出现≥2级急性肺毒性。
SBRT对I期NSCLC患者安全有效。然而，对于T2肿瘤应考虑更强化的治疗方案。
