Department of Radiation Oncology, University of Arizona , Tucson, AZ , USA.
Front Oncol. 2013 Nov 26;3:289. doi: 10.3389/fonc.2013.00289. eCollection 2013.
To assess the tolerance of patients with small cell lung cancer undergoing chemoradiation with tomotherapy-based image-guided radiotherapy (IGRT).
A retrospective review of the toxicity profile for nine patients with small cell lung cancer of the limited stage who underwent chemoradiation delivered with helical tomotherapy (HT) has been conducted.
Acute grade 3-4 hematologic and esophagitis toxicities developed in two and three patients respectively. One patient developed a pulmonary embolism during radiotherapy. Seven patients had weight loss ranging from 0 to 30 pounds (median: 4 pounds). Three patients had treatment breaks ranging from 2 to 12 days. At a median follow-up of 11 months (range: 2-24 months), no patients developed any radiation related toxicities such as grade 3-4 pneumonitis or other long-term complications. The median survival was estimated to be 15 months. There were two local recurrences, three mediastinal recurrences, and six distant metastases.
Grade 3-4 toxicities remained significant during chemoradiation when radiation was delivered with tomotherapy-based IGRT. However, the absence of grade 3-4 pneumonitis is promising and the use of HT needs to be investigated in future prospective studies.
评估接受基于螺旋断层放疗(IGRT)的放化疗的小细胞肺癌患者的耐受性。
对 9 例局限期小细胞肺癌患者接受螺旋断层放疗(HT)进行放化疗的毒性特征进行回顾性分析。
分别有 2 例和 3 例患者出现急性 3-4 级血液学和食管炎毒性。1 例患者在放疗期间发生肺栓塞。7 例患者体重减轻 0-30 磅(中位数:4 磅)。3 例患者治疗中断 2-12 天。中位随访 11 个月(范围:2-24 个月),无患者出现任何与放疗相关的毒性,如 3-4 级放射性肺炎或其他长期并发症。中位生存期估计为 15 个月。有 2 例局部复发,3 例纵隔复发,6 例远处转移。
当使用基于螺旋断层放疗的 IGRT 进行放疗时,放化疗期间仍存在显著的 3-4 级毒性。然而,没有出现 3-4 级放射性肺炎是有希望的,需要在未来的前瞻性研究中进一步探讨 HT 的应用。