Nagai Aiko, Shibamoto Yuta, Yoshida Masanori, Inoda Koji, Kikuchi Yuzo
Radiation Therapy Center, Fukui Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan ; Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Biomed Res Int. 2014;2014:473173. doi: 10.1155/2014/473173. Epub 2014 Jun 4.
Stereotactic body radiotherapy (SBRT) proved to be an effective treatment with acceptable toxicity for lung tumors. However, the use of helical intensity-modulated (IM) SBRT is controversial. We investigated the outcome of lung tumor patients treated by IMSBRT using helical tomotherapy with a Japanese standard fractionation schedule of 48 Gy in 4 fractions (n = 37) or modified protocols of 50-60 Gy in 5-8 fractions (n = 35). Median patient's age was 76 years and median follow-up period for living patients was 20 months (range, 6-46). The median PTV was 6.9 cc in the 4-fraction group and 14 cc in the 5- to 8-fraction group (P = 0.001). Grade 2 radiation pneumonitis was seen in 2 of 37 patients in the 4-fraction group and in 2 of 35 patients in the 5- to 8-fraction group (log-rank P = 0.92). Other major complications were not observed. The LC rates at 2 years were 87% in the 4-fraction group and 83% in the 5- to 8-fraction group. Helical IMSBRT for lung tumors is safe and effective. Patients with a high risk of developing severe complications may also be safely treated using 5-8 fractions. The results of the current study warrant further studies of helical IMSBRT.
立体定向体部放射治疗（SBRT）被证明是一种治疗肺部肿瘤有效的方法，且毒性可接受。然而，螺旋调强（IM）SBRT的应用存在争议。我们研究了采用螺旋断层放疗进行IM-SBRT治疗的肺部肿瘤患者的治疗结果，治疗方案采用日本标准分割方案，48 Gy分4次照射（n = 37），或改良方案，50 - 60 Gy分5 - 8次照射（n = 35）。患者的中位年龄为76岁，存活患者的中位随访期为20个月（范围6 - 46个月）。4分次组的计划靶体积（PTV）中位数为6.9 cc，5 - 8分次组为14 cc（P = 0.001）。4分次组37例患者中有2例发生2级放射性肺炎，5 - 8分次组35例患者中有2例发生（对数秩检验P = 0.92）。未观察到其他主要并发症。4分次组和5 - 8分次组的2年局部控制率分别为87%和83%。螺旋IM-SBRT治疗肺部肿瘤安全有效。发生严重并发症风险高的患者采用5 - 8分次照射也可安全治疗。本研究结果值得对螺旋IM-SBRT进行进一步研究。
