Department of Radiation Oncology, Mayo Clinic, Rochester, USA.
Radiother Oncol. 2011 May;99(2):166-71. doi: 10.1016/j.radonc.2011.04.002. Epub 2011 May 14.
Identify the incidence of early pulmonary toxicity in a cohort of patients treated with lung stereotactic body radiation therapy (SBRT) on consecutive treatment days.
A total of 88 lesions in 84 patients were treated with SBRT in consecutive daily fractions (Fx) for medically inoperable non-small cell lung cancer or metastasis. The incidence of pneumonitis was evaluated and graded according to the NCI CTCAE v3.0.
With a median follow-up of 15.8 months (range 2.5-28.6), the median age at SBRT was 71.8 years (range 23.8-87.8). 47 lesions were centrally located and 41 were peripheral. Most central lesions were treated with 48Gy in 4 Fx, and most peripheral lesions with 54Gy in 3 Fx. The incidence of grade ≥ 2 pneumonitis was 12.5% in all patients treated, and 14.3% among the subset of patients treated with 54Gy in 3 Fx. A total of two grade 3 toxicities were seen as one grade 5 toxicity in a patient treated for recurrence after pneumonectomy.
Treating both central and peripheral lung lesions with SBRT in consecutive daily fractions in this cohort was well tolerated and did not cause excessive early pulmonary toxicity.
在连续治疗日内接受肺部立体定向体部放射治疗（SBRT）的患者队列中，确定早期肺毒性的发生率。
共 84 例患者的 88 个病灶接受了 SBRT 连续每日分次治疗（Fx），适用于无法手术的非小细胞肺癌或转移病灶。根据 NCI CTCAE v3.0 评估和分级肺炎的发生率。
中位随访时间为 15.8 个月（范围 2.5-28.6），SBRT 时的中位年龄为 71.8 岁（范围 23.8-87.8）。47 个病灶位于中央，41 个病灶位于周围。大多数中央病灶采用 48Gy/4Fx 治疗，大多数周围病灶采用 54Gy/3Fx 治疗。所有接受治疗的患者中，≥2 级肺炎的发生率为 12.5%，接受 54Gy/3Fx 治疗的患者中为 14.3%。在 1 例因肺切除术后复发而接受治疗的患者中，共观察到 2 例 3 级毒性和 1 例 5 级毒性。
在本队列中，对中央和周围肺部病灶进行 SBRT 连续每日分次治疗，耐受性良好，不会导致早期过度肺毒性。
