Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Thorac Oncol. 2012 Feb;7(2):453-6. doi: 10.1097/JTO.0b013e31823c5b29.
Long-term outcomes remain unknown after stereotactic body radiation therapy (SBRT). We observed a few patients who developed disease progression late, at 5 years or more, after SBRT. In this report, we describe the characteristics of those patients with late recurrence after SBRT.
We retrospectively reviewed patients who underwent SBRT for non-small cell lung cancer with histological confirmation between January 1999 and December 2005 at our institution. During this period, 48 Gy of SBRT in four fractions at the isocenter was prescribed for all patients.
In total, 66 patients were eligible. With a median follow-up period of 35.9 months, the 5-year overall survival and disease-free survival rates were 44.6% (95% confidence interval, 33.5-59.5%) and 33.8% (95% confidence interval, 23.6-48.4%), respectively. Of the patients, 16 survived without disease progression for 5 years or more after SBRT. Of these, four patients developed late recurrence at 76, 101, 108, and 109 months after SBRT. Three of the patients were females with adenocarcinomas; the other was a male with squamous cell carcinoma. The initial sites of recurrence were local in two patients, distant in one, and simultaneously local and distant in one. A total of two patients with local recurrence alone were still alive at 138 months after SBRT.
The rate of late recurrence was not negligible in long-term survivors after SBRT. Our experiences indicate that long-term follow-up is needed after SBRT for non-small cell lung cancer.
立体定向体部放射治疗（SBRT）后长期结果仍不清楚。我们观察到少数患者在 SBRT 后 5 年或更长时间出现疾病进展。在本报告中，我们描述了 SBRT 后晚期复发患者的特征。
我们回顾性分析了 1999 年 1 月至 2005 年 12 月期间在我院接受组织学证实的非小细胞肺癌 SBRT 的患者。在此期间，所有患者在等中心点处接受 48 Gy 的 SBRT，共 4 次。
共有 66 例患者符合条件。中位随访时间为 35.9 个月，5 年总生存率和无疾病生存率分别为 44.6%（95%置信区间，33.5-59.5%）和 33.8%（95%置信区间，23.6-48.4%）。在这些患者中，有 16 例在 SBRT 后 5 年或以上无疾病进展生存。其中，4 例在 SBRT 后 76、101、108 和 109 个月时出现晚期复发。4 例为女性，腺癌；1 例为男性，鳞癌。2 例患者最初的复发部位为局部，1 例为远处，1 例为局部和远处同时。2 例单纯局部复发的患者在 SBRT 后 138 个月仍存活。
SBRT 后长期生存者的晚期复发率不容忽视。我们的经验表明，非小细胞肺癌 SBRT 后需要长期随访。
