Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):463-7. doi: 10.1016/j.ijrobp.2010.10.001. Epub 2010 Nov 20.
To investigate the relationship between waiting time (WT) and disease progression in patients undergoing stereotactic body radiotherapy (SBRT) for lung adenocarcinoma (AD) or squamous cell carcinoma (SQ).
201 patients with Stage I AD or SQ undergoing SBRT between January 2004 and June 2010 were analyzed. The WT was defined as the interval between diagnostic computed tomography before referral and computed tomography for treatment planning or positioning before SBRT. Tumor size was measured on the slice of the longest tumor diameter, and tumor volume was calculated from the longest diameter and the diameter perpendicular to it. Changes in tumor volume and TNM stage progression were evaluated, and volume doubling time (VDT) was estimated.
The median WT was 42 days (range, 5-323 days). There was a correlation between WT and rate of increase in volume in both AD and SQ. The median VDTs of AD and SQ were 170 and 93 days, respectively. Thirty-six tumors (23%) did not show volume increase during WTs >25 days. In 41 patients waiting for ≤4 weeks, no patient showed T stage progression, whereas in 25 of 120 (21%) patients waiting for >4 weeks, T stage progressed from T1 to T2 (p = 0.001). In 10 of 110 (9.1%) T1 ADs and 15 of 51 (29%) T1 SQs, T stage progressed (p = 0.002). N stage and M stage progressions were not observed.
Generally, a WT of ≤4 weeks seems to be acceptable. The WT seems to be more important in SQ than in AD.
研究肺腺癌（AD）或鳞状细胞癌（SQ）患者行立体定向体部放疗（SBRT）的等待时间（WT）与疾病进展的关系。
对 2004 年 1 月至 2010 年 6 月期间行 SBRT 的 201 例 I 期 AD 或 SQ 患者进行了分析。WT 定义为转诊前的诊断性 CT 检查与 SBRT 前的 CT 治疗计划或定位之间的间隔。肿瘤大小在最长肿瘤直径的切片上测量，肿瘤体积由最长直径和垂直于最长直径的直径计算得出。评估了肿瘤体积的变化和 TNM 分期进展，并估计了倍增时间（VDT）。
中位 WT 为 42 天（范围，5-323 天）。AD 和 SQ 中 WT 与体积增长率之间均存在相关性。AD 和 SQ 的中位 VDT 分别为 170 天和 93 天。36 个肿瘤（23%）在 WT>25 天时没有显示体积增加。在等待≤4 周的 41 例患者中，没有患者 T 分期进展，而在等待>4 周的 120 例患者中的 25 例（21%）中，T 分期从 T1 进展为 T2（p=0.001）。在 110 例 T1 AD 中的 10 例（9.1%）和 51 例 T1 SQ 中的 15 例（29%）中，T 分期进展（p=0.002）。未观察到 N 分期和 M 分期进展。
一般来说，WT≤4 周似乎是可以接受的。WT 在 SQ 中似乎比在 AD 中更为重要。
