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[立体定向放射治疗Ⅰ期和Ⅱ期肺癌:33例患者的研究]

[Stereotactic radiotherapy for stage I and II lung cancer: a study of 33 patients].

作者信息

Champeaux-Orange E, Wachter T, Bouscayrol H, Barillot I

机构信息

Service d'oncologie-radiothérapie, CHR d'Orléans-La Source, Orléans, France.

出版信息

Cancer Radiother. 2011 Jun;15(3):192-6. doi: 10.1016/j.canrad.2010.10.002. Epub 2011 Feb 16.

Abstract

PURPOSE

Surgery is the main treatment of early stage non small cell lung cancer. However, in inoperable patients, the treatment is usually conventional radiotherapy. Results are poor and acute toxicity is severe. Stereotactic body radiation therapy provides better results in terms of local control and toxicity. Our purpose was to evaluate the clinical outcomes of patients with primary lung tumours treated by stereotactic body radiation therapy using a stereotactic body frame at the Orléans Regional Hospital.

PATIENTS AND METHODS

Between June 2000 and December 2007, 33 patients with stage I and II non small cell lung cancer were treated by stereotactic body radiation therapy. Breathing control was obtained by passive diaphragm control. Two CT-scans were performed 1 week apart to determine the accuracy of patient repositioning and define target volumes. Five or six fields were set up to achieve a conformal dose distribution. According to tumour size, a total of 50 or 40 Gy was delivered in 10 fractions.

RESULTS

Mean patient age was 70 years. Median follow-up was 25 months. Ten patients with a complete response are still alive. Eight patients have died from local progression, eight from metastasis, and six from comorbidity. Median disease-free survival was 22.6 months. No acute toxicity up to grade II (CTC AE 3.0) was observed. None of the patients still alive has developed any complications.

CONCLUSION

In patients who cannot undergo radical surgery, stereotactic body radiation therapy using a sterotactic body frame is well-tolerated and seems to be an efficient treatment method.

摘要

目的

手术是早期非小细胞肺癌的主要治疗方法。然而,对于无法手术的患者,治疗通常采用传统放疗。其效果不佳且急性毒性严重。立体定向体部放射治疗在局部控制和毒性方面能提供更好的效果。我们的目的是评估在奥尔良地区医院使用立体定向体架对原发性肺肿瘤患者进行立体定向体部放射治疗的临床结果。

患者与方法

2000年6月至2007年12月期间,33例I期和II期非小细胞肺癌患者接受了立体定向体部放射治疗。通过被动膈肌控制实现呼吸控制。相隔1周进行两次CT扫描,以确定患者重新定位的准确性并确定靶区体积。设置五或六个射野以实现适形剂量分布。根据肿瘤大小,分10次给予总共50或40 Gy的剂量。

结果

患者平均年龄为70岁。中位随访时间为25个月。10例完全缓解的患者仍然存活。8例患者死于局部进展,8例死于转移,6例死于合并症。中位无病生存期为22.6个月。未观察到高达II级(CTC AE 3.0)的急性毒性。所有仍存活的患者均未出现任何并发症。

结论

对于无法进行根治性手术的患者,使用立体定向体架进行立体定向体部放射治疗耐受性良好,似乎是一种有效的治疗方法。

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