Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA.
Chest. 2013 Jun;143(6):1784-1790. doi: 10.1378/chest.12-2580.
Lung cancer remains the leading cause of death worldwide. Because many patients with non-small cell lung cancer are elderly and have multiple comorbid conditions, many with potentially curable disease are unfit to undergo definitive surgical resection. Stereotactic body radiation therapy (SBRT) is increasingly being used to treat patients with medically inoperable stage I non-small cell lung cancer. SBRT combines reproducible and accurate anatomic targeting with the delivery of a very high dose per fraction of radiation to a target. Planning and delivery of SBRT is a coordinated effort between the radiation oncology team and consulting services. Clinical outcomes, toxicity profiles, treatment delivery, and indications for SBRT are reviewed. Services currently billed during planning and treatment of SBRT are detailed. This article introduces to consulting specialists and subspecialists a new Current Procedural Terminology code that has been proposed to more accurately reflect work performed during SBRT by these consulting providers. This code is described, and its implications for patient care are discussed.
肺癌仍然是全球主要的致死原因。由于许多非小细胞肺癌患者年龄较大且合并多种合并症,许多潜在可治愈的疾病患者不适合进行确定性手术切除。立体定向体部放射治疗(SBRT)越来越多地被用于治疗不能手术的 I 期非小细胞肺癌患者。SBRT 将可重复性和准确性的解剖定位与每次放射治疗的高剂量相结合。SBRT 的计划和实施需要放射肿瘤团队与咨询服务之间的协作。本文回顾了 SBRT 的临床结果、毒性特征、治疗实施以及适应症。本文详细介绍了在 SBRT 计划和治疗过程中目前计费的服务。本文向咨询专家和亚专业专家介绍了一个新的当前操作编码(Current Procedural Terminology code),该编码旨在更准确地反映这些咨询提供者在 SBRT 期间的工作。本文对该编码进行了描述,并讨论了其对患者护理的影响。