Ochiai Satoru, Yamakado Koichiro, Kodama Hiroshi, Nomoto Yoshihito, Ii Noriko, Takaki Haruyuki, Sakuma Hajime
Department of Radiation Oncology, Matsusaka Central Hospital, 102 Kobou Kawaimachi, Matsusaka, Mie, 515-8566, Japan.
Int J Clin Oncol. 2015 Jun;20(3):499-507. doi: 10.1007/s10147-014-0741-z. Epub 2014 Aug 19.
This retrospective study was conducted to compare the clinical outcomes of radiofrequency ablation (RFA) with those of stereotactic body radiotherapy (SBRT) in patients with lung tumors.
Local tumor progression, adverse events, and overall survival were compared in patients who underwent either RFA or SBRT for a single lung tumor measuring 5 cm or smaller. This study was approved by the institutional review boards of two institutions. Informed consent was waived.
During September 2009 to June 2012, 48 patients [30 males and 18 females, with a mean age ± standard deviation (SD) of 75.0 ± 7.5 years] underwent RFA at one institution and 47 patients (21 males and 26 females, with a mean age ± SD of 77.0 ± 7.5 years) underwent SBRT in another. The mean maximum tumor diameter ± SD was 2.0 ± 0.8 cm (range 0.6-3.9 cm) in the RFA group, and 2.1 ± 0.9 cm (range 0.8-4.7 cm, p = 0.539) in the SBRT group. The RFA and SBRT groups showed similar 3-year local tumor progression [9.6%, 95% confidence interval (CI) 3.6-23.9% vs. 7.0%, 95% CI 0.2-20.2%, p = 0.746] and overall survival rates (86.4%, 95% CI 69.2-94.3% vs. 79.6%, 95% CI 60.6-90.1%, p = 0.738). No factor significantly affected local tumor progression. A maximum tumor size of 2 cm was identified as a prognostic factor in both univariate and multivariate analyses. No death was related to treatment procedures. Major complication rates (Grade 3 adverse events) of the RFA (10.4%, 5/48) and SBRT (8.5%, 4/47, p > 0.999) groups were similar.
For lung tumor patients, lung RFA provided local tumor control and survival that were similar to those achieved using SBRT, with equal safety.
本回顾性研究旨在比较射频消融(RFA)与立体定向体部放疗(SBRT)治疗肺肿瘤患者的临床疗效。
对接受RFA或SBRT治疗单个直径5 cm及以下肺肿瘤的患者的局部肿瘤进展、不良事件和总生存率进行比较。本研究经两家机构的机构审查委员会批准。无需知情同意。
2009年9月至2012年6月,一家机构有48例患者(30例男性和18例女性,平均年龄±标准差[SD]为75.0±7.5岁)接受了RFA治疗,另一家机构有47例患者(21例男性和26例女性,平均年龄±SD为77.0±7.5岁)接受了SBRT治疗。RFA组的平均最大肿瘤直径±SD为2.0±0.8 cm(范围0.6 - 3.9 cm),SBRT组为2.1±0.9 cm(范围0.8 - 4.7 cm,p = 0.539)。RFA组和SBRT组的3年局部肿瘤进展情况相似[9.6%,95%置信区间(CI)3.6 - 23.9% vs. 7.0%,95% CI 0.2 - 20.2%,p = 0.746],总生存率也相似(86.4%,95% CI 69.2 - 94.3% vs. 79.6%,95% CI 60.6 - 90.1%,p = 0.738)。没有因素对局部肿瘤进展有显著影响。在单因素和多因素分析中,最大肿瘤大小为2 cm被确定为一个预后因素。没有死亡与治疗程序相关。RFA组(10.4%,5/48)和SBRT组(8.5%,4/47,p > 0.999)的主要并发症发生率(3级不良事件)相似。
对于肺肿瘤患者,肺部RFA提供的局部肿瘤控制和生存率与SBRT相似,且安全性相当。