Department of Radiation Oncology at the Oncologic Referral Center of Aviano, Italy.
Lung Cancer. 2010 Jul;69(1):77-85. doi: 10.1016/j.lungcan.2009.09.006. Epub 2009 Nov 11.
To describe early and late CT patterns of radiographic lung injury after SBRT for lung cancer, and to correlate radiological findings with patient and treatment characteristics.
Follow-up CT scans of 68 patients with 70 tumors were divided into 4 periods: (1) 6 weeks; (2) 2-6 months; (3) 7-12 months and (4) 13-18 months after SBRT. Early (within 6 months) and late radiological injuries were evaluated according to Ikezoe and Koening, respectively. The correlation between CT findings and patient characteristics was evaluated.
Radiographic injury in periods 1 and 2 was: (1) diffuse consolidation 3 and 27%, (2) patchy consolidation and ground-glass opacity (GGO) 13.2 and 33%, (3) diffuse GGO 13.2 and 21%, (4) patchy GGO 16.2 and 6%, and (5) no findings 54.4 and 21%, respectively. Late injury in periods 3 and 4 were: (1) modified conventional pattern (consolidation, volume loss, bronchiectasis) 54 and 44%, (2) mass-like 20 and 28%, (3) scar-like 14 and 16% and (4) no findings 20 and 12%, respectively. The proportion of emphysema grades 2-4 was significantly higher in patients who had no radiological findings 6 weeks after treatment (p=0.021). Both patchy consolidation and GGO patterns resulted more frequently in patients who were not administered steroids (p=0.035). No relationship was found with smoking, tumor dimension and radiation dose.
The majority of patients had no evidence of radiographic lung injury 6 weeks after SBRT; the most prevalent findings were diffuse or patchy GGO. Patchy and diffuse consolidation develops 2-6 months after SBRT. Modified conventional pattern was the most prevalent in the late periods.
描述肺癌 SBRT 后早期和晚期 CT 肺部放射性损伤的模式，并将影像学发现与患者和治疗特征相关联。
对 68 例 70 个肿瘤的 SBRT 后随访 CT 扫描进行分组，分为 4 个时期：（1）6 周内；（2）2-6 个月；（3）7-12 个月；（4）13-18 个月。根据 Ikezoe 和 Koening 分别评估早期（6 个月内）和晚期的放射性损伤。评估 CT 表现与患者特征之间的相关性。
第 1 期和第 2 期的放射性损伤为：（1）弥漫性实变 3 例，27%；（2）斑片状实变和磨玻璃影（GGO）13.2%，33%；（3）弥漫性 GGO 13.2%，21%；（4）斑片状 GGO 16.2%，6%；（5）无发现 54.4%，21%。第 3 期和第 4 期的晚期损伤为：（1）改良常规模式（实变、体积丢失、支气管扩张）54%，44%；（2）肿块样 20%，28%；（3）瘢痕样 14%，16%；（4）无发现 20%，12%。治疗后 6 周无影像学发现的患者中，2-4 级肺气肿的比例明显更高（p=0.021）。未给予类固醇治疗的患者中，斑片状实变和 GGO 模式更为常见（p=0.035）。与吸烟、肿瘤大小和辐射剂量均无关系。
大多数患者在 SBRT 后 6 周无放射性肺损伤证据；最常见的发现是弥漫性或斑片状 GGO。SBRT 后 2-6 个月出现斑片状和弥漫性实变。在晚期，改良常规模式最为常见。
