胸膜外全肺切除术后间皮瘤的辅助放疗。多机构系列的前瞻性分析。
Adjuvant radiotherapy after extrapleural pneumonectomy for mesothelioma. Prospective analysis of a multi-institutional series.
机构信息
Department of Radiation Oncology, Brescia University, Italy.
出版信息
Radiother Oncol. 2011 Nov;101(2):311-5. doi: 10.1016/j.radonc.2011.09.025. Epub 2011 Nov 11.
BACKGROUND AND PURPOSE
To evaluate survival, locoregional control and toxicity in a series of 56 mesothelioma patients treated from May 2005 to May 2010 with post-operative radiotherapy after extrapleural pneumonectomy (EPP) in three Italian Institutions (Brescia, Florence, and Modena).
MATERIAL AND METHODS
Fifty-six patients treated with adjuvant radiotherapy (RT) after EPP were analyzed. Four patients were treated with 3DCRT, 50 with IMRT and two with helical tomotherapy. Forty-five to 50 Gy in 25 fractions were given to the affected hemithorax and to ipsilateral mediastinum, with a simultaneous integrated boost to the sites of microscopically involved margins up to 60 Gy in 20/56 cases.
RESULTS
Three year locoregional control (LRC), distant metastasis free (DMF), disease free (DF), disease specific (DSS) and overall survival (OS) rates are 90%, 66%, 57%, 62%, and 60%, respectively.
CONCLUSION
Postoperative RT with modern techniques is an effective method to obtain excellent local control and cure rates in mesothelioma patients submitted to EPP.
背景与目的
评估在意大利三个机构（布雷西亚、佛罗伦萨和摩德纳）进行的 56 例间皮瘤患者中，术后放疗在胸腔外全肺切除术后（EPP）的疗效，包括生存率、局部区域控制率和毒性。
材料与方法
对 56 例接受 EPP 辅助放疗（RT）的患者进行了分析。4 例患者接受 3DCRT 治疗，50 例患者接受 IMRT 治疗，2 例患者接受螺旋断层放疗。45-50Gy/25 次，用于受累半胸和同侧纵隔，同时对显微镜下受累边缘进行同步整合增敏，20/56 例达到 60Gy。
结果
3 年局部区域控制（LRC）、远处无转移（DMF）、无病（DF）、疾病特异性（DSS）和总生存率（OS）分别为 90%、66%、57%、62%和 60%。
结论
EPP 术后采用现代技术进行放疗是一种有效的方法，可以获得间皮瘤患者优异的局部控制和治愈率。
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