Hatime M, Elmorabit B, Elkhoti Y, Touch S, Tanguy R, Mornex F
Département de radiothérapie oncologie, centre hospitalier Lyon-Sud, Pierre-Bénite, France.
Cancer Radiother. 2012 Sep;16(5-6):351-7. doi: 10.1016/j.canrad.2012.07.184. Epub 2012 Aug 24.
Metastatic lung disease has long been the preserve of systemic treatments, local treatments being considered in a purely palliative intention. Several studies have objectified benefit to the local treatment of metastases, especially oligometastases. Surgery then took an important place in this setting, but the development of techniques for stereotactic radiotherapy on the one hand and the refusal or contraindication for surgery on the other hand led authors to conduct studies in this direction. This literature review describes the realization of stereotactic radiotherapy in treating pulmonary oligometastases and evaluates criteria for the selection of patients who would benefit. A comparison between the results of different studies on this technique allowed to show its effectiveness for local control, overall survival and tolerance. Stereotactic radiotherapy has emerged as a viable alternative, effective and well tolerated with local control rates comparable to that obtained by surgery (74 to 100%). Quality of life after stereotactic radiotherapy should be in a near future an important parameter to support this therapeutic choice, and needs to be precisely assessed.
转移性肺病长期以来一直采用全身治疗,局部治疗仅出于纯粹的姑息目的。多项研究已证实局部治疗转移灶,尤其是寡转移灶具有益处。手术在这种情况下占据了重要地位,但一方面立体定向放射治疗技术的发展,另一方面对手术的拒绝或禁忌,促使作者们朝着这个方向开展研究。这篇文献综述描述了立体定向放射治疗在治疗肺部寡转移灶方面的应用,并评估了可能受益患者的选择标准。对该技术不同研究结果的比较显示了其在局部控制、总生存期和耐受性方面的有效性。立体定向放射治疗已成为一种可行的替代方案,有效且耐受性良好,局部控制率与手术相当(74%至100%)。立体定向放射治疗后的生活质量在不久的将来应成为支持这一治疗选择的重要参数,并且需要进行精确评估。