Amini Arya, Yeh Norman, Gaspar Laurie E, Kavanagh Brian, Karam Sana D
Department of Radiation Oncology, The University of Colorado School of Medicine, 1665 Aurora Court, Room 1032, Aurora, CO 80045, USA.
Radiat Oncol. 2014 Sep 19;9:210. doi: 10.1186/1748-717X-9-210.
Lung cancer continues to be one of the most prevalent malignancies worldwide and is the leading cause of death in both men and women. Presently, local control rates are quite poor. Improvements in imaging and radiation treatment delivery systems however have provided radiation oncologists with new tools to better target these tumors. Stereotactic body radiation therapy (SBRT) is one such technique that has shown efficacy as upfront treatment for lung cancer. In addition, more recent studies have demonstrated some effectiveness in recurrent tumors in prior irradiated fields as well. This review summarizes seven recent studies of re-irradiation with SBRT in patients with thoracic recurrences treated previously with conventionally fractionated radiation therapy. Combined, 140 patients were included. The median initial thoracic radiation doses ranged from 50-87.5 Gy and median re-irradiation dose ranged from 40-80 Gy. Local control rates varied from 65-92%. Re-irradiation was well tolerated with few grade 4 and 5 complications (observed in one study). Currently, based on these published reports, re-irradiation with SBRT appears feasible for in-field thoracic recurrences, though caution must be taken in all cases of retreatment.
肺癌仍然是全球最常见的恶性肿瘤之一，也是男性和女性的主要死因。目前，局部控制率相当低。然而，成像和放射治疗输送系统的改进为放射肿瘤学家提供了更好地靶向这些肿瘤的新工具。立体定向体部放射治疗（SBRT）就是这样一种已显示出作为肺癌一线治疗有效的技术。此外，最近的研究还表明，它对先前照射区域的复发性肿瘤也有一定疗效。本综述总结了最近七项关于SBRT再程放疗的研究，这些研究针对的是先前接受过常规分割放疗的胸部复发患者。这些研究共纳入了140例患者。初始胸部放疗的中位剂量范围为50 - 87.5 Gy，再程放疗的中位剂量范围为40 - 80 Gy。局部控制率在65% - 92%之间。再程放疗耐受性良好，4级和5级并发症较少（在一项研究中观察到）。目前，基于这些已发表的报告，SBRT再程放疗对于胸部野内复发似乎是可行的，不过在所有再治疗病例中都必须谨慎。
