Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancers (Basel). 2011 Sep 1;3(3):3432-48. doi: 10.3390/cancers3033432.
Treatment options for early-stage (T1-2 N0) non-small cell lung cancer are often limited by the patient's advanced age, poor performance status, and comorbidities. Despite these challenges, stereotactic ablative radiotherapy (SABR) provides a highly effective and safe therapy for intrathoracic tumors and has become the standard of care for delivering definitive treatment in medically inoperable patients. High-quality treatment, which includes reliable immobilization, accurate tumor targeting, and precise verification of dose delivery, is essential both to achieve successful cure and to avoid debilitating toxicities. Generally, SABR is well tolerated in patients with peripherally located tumors, but even centrally or superiorly located lesions can be treated if there is adequate conformal avoidance of normal structures and/or modified fractionation to meet dose constraints. While several preliminary studies suggest that SABR is as efficacious as surgery in operable patients, results of randomized data will illuminate whether the indications for SABR can be expanded to include patients who are candidates for surgical resection. Herein, we review the rationale for using SABR and its application in treating different patient populations with early-stage lung cancer.
早期（T1-2 N0）非小细胞肺癌的治疗选择通常受到患者年龄较大、身体状况不佳和合并症的限制。尽管存在这些挑战，立体定向消融放疗（SABR）仍是一种针对胸内肿瘤的高效且安全的治疗方法，已成为无法进行手术的患者进行确定性治疗的标准方法。高质量的治疗，包括可靠的固定、准确的肿瘤定位和精确的剂量验证，对于成功治愈和避免致残毒性都至关重要。通常情况下，SABR 治疗外周肿瘤的患者耐受性良好，但如果能够充分避开正常结构并进行适形保护，或者采用改良分割以满足剂量限制，即使是中央或高位肿瘤也可以进行治疗。虽然一些初步研究表明 SABR 在可手术患者中的疗效与手术相当，但随机数据的结果将阐明 SABR 的适应证是否可以扩大到包括适合手术切除的患者。本文综述了 SABR 的应用原理及其在治疗不同人群早期肺癌中的应用。
