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立体定向体部放疗用于寡转移复发性肺癌:42例分析

Stereotactic body radiotherapy for metastatic lung cancer as oligo-recurrence: an analysis of 42 cases.

作者信息

Takahashi Wataru, Yamashita Hideomi, Niibe Yuzuru, Shiraishi Kenshiro, Hayakawa Kazushige, Nakagawa Keiichi

机构信息

Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

出版信息

Pulm Med. 2012;2012:454107. doi: 10.1155/2012/454107. Epub 2012 Oct 4.

Abstract

Purpose. To investigate the outcome and toxicity of stereotactic body radiotherapy (SBRT) in patients with oligo-recurrence cancer in the lung (ORCL). Methods and Materials. A retrospective review of 42 patients with ORCL who underwent SBRT in our two hospitals was conducted. We evaluated the outcome and adverse effects after SBRT for ORCL. Results. All patients finished their SBRT course without interruptions of toxicity reasons. The median follow-up period was 20 months (range, 1-90 months). The 2-year local control rate and overall survival were 87% (95% CI, 75-99%) and 65% (95% CI, 48-82%). As for prognostic factor, the OS of patients with a short disease-free interval (DFI) <31.9 months, between the initial therapy and SBRT for ORCL, was significantly worse than the OS of long DFI ≧31.9 months (P < 0.05). The most commonly observed late effect was radiation pneumonitis. One patient had grade 4 gastrointestinal toxicity (perforation of gastric tube). No other ≧ grade 3 acute and late adverse events occurred. There were no treatment-related deaths during this study. Conclusions. In patients with ORCL, radical treatment with SBRT is safe and provides a chance for long-term survival by offering favorable local control.

摘要

目的。探讨立体定向体部放疗(SBRT)治疗肺部寡复发癌(ORCL)患者的疗效和毒性。方法与材料。对在我们两家医院接受SBRT治疗的42例ORCL患者进行回顾性研究。我们评估了SBRT治疗ORCL后的疗效和不良反应。结果。所有患者均完成了SBRT疗程,无因毒性原因中断治疗。中位随访期为20个月(范围1 - 90个月)。2年局部控制率和总生存率分别为87%(95%可信区间,75 - 99%)和65%(95%可信区间,48 - 82%)。作为预后因素,初始治疗与ORCL的SBRT之间无病间期(DFI)<31.9个月的患者的总生存期明显差于DFI≥31.9个月的患者(P < 0.05)。最常见的晚期效应是放射性肺炎。1例患者出现4级胃肠道毒性(胃管穿孔)。未发生其他≥3级的急性和晚期不良事件。本研究期间无治疗相关死亡。结论。对于ORCL患者,SBRT根治性治疗是安全的,并通过提供良好的局部控制为长期生存提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc45/3472526/5c4a015ac78c/PM2012-454107.001.jpg

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