Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Strahlenther Onkol. 2010 May;186(5):274-9. doi: 10.1007/s00066-010-2072-y. Epub 2010 Apr 26.
High-dose irradiation to the pulmonary hilar region is generally considered to be of high risk in causing bronchial injury. The aim of this retrospective study is to investigate the safety and efficacy of stereotactic body radiotherapy (SBRT) for patients with lung tumors in the pulmonary hilum.
21 patients who underwent SBRT for lung tumors within 2 cm from a major bronchus were retrospectively analyzed. The total biologically effective doses ranging from 50.7 to 157.5 Gy (median, 100 Gy) were given to the tumors by SBRT.
The overall survival rates at 1 and 2 years after SBRT were 90.0% and 62.2%, respectively. Nine patients were alive and 15 irradiated tumors were controlled during the follow-up period of 10-54 months (median, 20 months). Nine patients died of tumor progression and one patient each died of hemoptysis, infectious pneumonia, and epidural hemorrhage. Severe late toxicity (>or= grade 3) was seen in three patients of whom two had previously received repeated radiotherapy.
SBRT for lung tumors located in the pulmonary hilar region may be tolerable and acceptable, if multiple treatments to the same major bronchus are avoided, and irradiated volumes are carefully taken into consideration.
高剂量照射肺门区域通常被认为有很高的支气管损伤风险。本回顾性研究旨在探讨立体定向体部放疗（SBRT）治疗肺门区肺部肿瘤的安全性和有效性。
回顾性分析了 21 例接受 SBRT 治疗的距主要支气管 2cm 内肺部肿瘤的患者。通过 SBRT，肿瘤的总生物有效剂量为 50.7 至 157.5Gy（中位数为 100Gy）。
SBRT 后 1 年和 2 年的总生存率分别为 90.0%和 62.2%。在 10-54 个月（中位数为 20 个月）的随访期间，9 例患者存活，15 例受照射肿瘤得到控制。9 例患者因肿瘤进展死亡，1 例患者因咯血、感染性肺炎和硬膜外出血死亡。3 例患者出现严重晚期毒性（≥3 级），其中 2 例患者曾接受过多次放疗。
如果避免对同一主要支气管进行多次治疗，并仔细考虑照射体积，SBRT 治疗肺门区肺部肿瘤可能是可耐受和可接受的。
