Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea.
J Thorac Oncol. 2010 Apr;5(4):526-32. doi: 10.1097/JTO.0b013e3181cbf622.
Retrospective analyses were performed on the patients with primary or metastatic lung cancer, who were treated with hypofractionated stereotactic radiation therapy (HSRT).
HSRT was applied to 43 patients since 2001 till 2007: 16 patients were with stage I primary lung cancer and 27 were with metastasis. Radiation was delivered in five consecutive daily fractions. The total doses were 50 Gy to 8 patients and 60 Gy to 35 patients. The median follow-up period was 21 months (range, 3-87 months). The effects of tumor size (<2.5 cm versus >or=2.5 cm) and radiation dose (50 Gy/5 fractions versus 60 Gy/5 fractions) on local tumor control were evaluated.
Local tumor progression occurred in three patients (6.9%). The 5-year local progression-free survival and cancer-specific survival rate were 89.4 and 53.3%, respectively. Tumors <2.5 cm resulted in higher crude local tumor control rate than tumors more than or equal to 2.5 cm (100.0% versus 82.3%, p = 0.05). In tumors more than or equal to 2.5 cm, the local tumor control rate was 66.7% with 50 Gy/5 fractions and 85.7% with 60 Gy/5 fractions (p = 0.46).
In HSRT for primary or metastatic lung cancers, smaller tumor size was significant prognostic factor for higher local control. Higher radiation dose than 50 Gy/5 fractions was needed in tumors more than or equal to 2.5 cm for local tumor control.
对接受立体定向放射治疗（HSRT）的原发性或转移性肺癌患者进行了回顾性分析。
2001 年至 2007 年，共对 43 例患者进行了 HSRT：16 例为 I 期原发性肺癌，27 例为转移癌。放射治疗分 5 个连续的每日剂量进行。8 例患者的总剂量为 50 Gy，35 例患者为 60 Gy。中位随访时间为 21 个月（范围 3-87 个月）。评估肿瘤大小（<2.5cm 与≥2.5cm）和剂量（50Gy/5 次与 60Gy/5 次）对局部肿瘤控制的影响。
3 例患者（6.9%）发生局部肿瘤进展。5 年局部无进展生存率和癌症特异性生存率分别为 89.4%和 53.3%。肿瘤<2.5cm 的粗局部肿瘤控制率高于肿瘤≥2.5cm（100.0%比 82.3%，p=0.05）。肿瘤≥2.5cm 时，50Gy/5 次的局部肿瘤控制率为 66.7%，60Gy/5 次的局部肿瘤控制率为 85.7%（p=0.46）。
在 HSRT 治疗原发性或转移性肺癌中，较小的肿瘤大小是更高局部控制的显著预后因素。肿瘤≥2.5cm 时，需要更高的剂量（50Gy/5 次）才能达到局部肿瘤控制。
