Matthiesen Chance, Thompson J Spencer, De La Fuente Herman Tania, Ahmad Salahuddin, Herman Terence
Stephenson Oklahoma Cancer Center, Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
J Med Imaging Radiat Oncol. 2012 Oct;56(5):561-6. doi: 10.1111/j.1754-9485.2012.02393.x.
To review outcomes of medically inoperable patients treated with stereotactic body radiation therapy (SBRT) for multiple primary lung cancer (MPLC).
We retrospectively reviewed the charts of 10 patients (21 lesions) treated with SBRT for synchronous (seven), metachronous (one) or synchronous/metachronous lung cancers. All patients were male, medically inoperable and had a median age of 66 years. Eight patients had bilateral disease and two had unilateral disease. All patients had a histological diagnosis in at least one of the two lesions and four patients (44.4%) had both lesions biopsied. There were 18 T1 lesions and three T2 lesions. SBRT was in three fractions of 20 Gy or five fractions of 11-12 Gy to each lesion.
Mean and median follow up were 18.8 and 15.5 months, respectively. At analysis, six patients (60.0%) are alive, and five of these living patients (83.3%) have no evidence of disease recurrence or progression. Four patients (44.4%) developed distant metastatic disease. Twenty lesions (95.2%) achieved in-field local control. No patients experienced acute pulmonary complications and only two patients (22.2%) experienced late grade I lung toxicity as per the Radiation Therapy Oncology Group toxicity criteria.
SBRT for MPLC in medically inoperable patients is a safe, feasible and effective treatment approach.
回顾立体定向体部放射治疗（SBRT）用于治疗多原发性肺癌（MPLC）中内科无法手术患者的治疗结果。
我们回顾性分析了10例（21个病灶）接受SBRT治疗的同步性（7例）、异时性（1例）或同步/异时性肺癌患者的病历。所有患者均为男性，内科无法手术，中位年龄66岁。8例患者为双侧病变，2例为单侧病变。所有患者至少在两个病灶中的一个有组织学诊断，4例患者（44.4%）两个病灶均进行了活检。有18个T1病灶和3个T2病灶。每个病灶给予SBRT，分3次，每次20 Gy，或分5次，每次11 - 12 Gy。
平均随访时间和中位随访时间分别为18.8个月和15.5个月。分析时，6例患者（60.0%）存活，其中5例存活患者（83.3%）无疾病复发或进展的证据。4例患者（44.4%）发生远处转移。20个病灶（95.2%）实现了靶区内局部控制。无患者发生急性肺部并发症，根据放射肿瘤学组毒性标准，仅2例患者（22.2%）发生1级晚期肺部毒性。
SBRT用于内科无法手术的MPLC患者是一种安全、可行且有效的治疗方法。
