Shen Ge, Wang Ying-Jie, Shen Wen-Jiang, Zhou Zhen-Shan, Wang Jun-Liang, Sheng Hong-Guo, Dong DA-Peng, Zhou Ming, Yang Gang, Wang Qin-Wen, Zeng Yanjun
Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, P.R. China.
Army Radiation Cancer Center and Department of Radiation Oncology, Air Force General Hospital, Beijing 100036, P.R. China.
Oncol Lett. 2014 Apr;7(4):1292-1296. doi: 10.3892/ol.2014.1815. Epub 2014 Jan 21.
The application of high-dose irradiation to centrally-located lung tumors is generally considered to be of high risk in causing bronchial injury. The aim of the present retrospective study was to investigate the safety and efficacy of stereotactic body radiation therapy (SBRT) for patients with centrally-located lung tumors. In total, 28 patients who underwent SBRT for lung tumors within 2 cm of a major bronchus were retrospectively analyzed. The median total dose prescribed was 45 Gy (range, 36.3-52.5 Gy), the median fraction was 12 (range, 10-15) and the median dose per fraction was 3.6 Gy (range, 3-5 Gy). The median follow-up period for the surviving patients was 14 months (range, 10-41 months). The local control rate of SBRT was 100%, with a complete response (CR) rate of 32.1% (9/28); a partial response (PR) rate of 50% (14/28) and a stable disease (SD) rate of 17.9% (5/28). In total, 15 patients survived and 13 patients succumbed; 11 patients succumbed to tumor progression, one to congestive heart failure and one to a brain hemorrhage. The main side-effects included grade 2 esophagitis (17.9%; 5/28) atelectasis (10.7%; 3/28) and grade 2 late radiation pneumonitis (7.1%; 2/28). Severe late toxicity (≥ grade 3) was not observed in any patient. SBRT is an effective and safe therapy for centrally-located lung tumors.
对位于中央的肺部肿瘤进行高剂量照射通常被认为具有导致支气管损伤的高风险。本回顾性研究的目的是调查立体定向体部放射治疗（SBRT）对位于中央的肺部肿瘤患者的安全性和有效性。总共对28例在距主支气管2 cm以内接受肺部肿瘤SBRT治疗的患者进行了回顾性分析。规定的中位总剂量为45 Gy（范围36.3 - 52.5 Gy），中位分次剂量为12次（范围10 - 15次），每次中位剂量为3.6 Gy（范围3 - 5 Gy）。存活患者的中位随访期为14个月（范围10 - 41个月）。SBRT的局部控制率为100%，完全缓解（CR）率为32.1%（9/28）；部分缓解（PR）率为50%（14/28），疾病稳定（SD）率为17.9%（5/28）。总共有15例患者存活，13例患者死亡；11例患者死于肿瘤进展，1例死于充血性心力衰竭，1例死于脑出血。主要副作用包括2级食管炎（17.9%；5/28）、肺不张（10.7%；3/28）和2级放射性肺炎（7.1%；2/28）。未观察到任何患者出现严重的晚期毒性（≥3级）。SBRT是一种治疗位于中央的肺部肿瘤的有效且安全的疗法。
