Okabe Tomoyuki, Kimura Tomoki, Nagata Yasushi
Dept. of Radiation Oncology, Hiroshima University Hospital.
Gan To Kagaku Ryoho. 2014 Dec;41(13):2543-5.
Stereotactic body radiotherapy(SBRT)is defined as the management and delivery of image-guided high-dose radiation therapy with tumor ablative intent within a short course of treatment. SBRT was more effective than 3D-CRT. In the phase II JCOG0403 trial for T1N0M0 non-small-cell lung cancer, the 3-year overall survival rate was 76% for operable patients and 59.9% for inoperable patients. Several authors reported the treatment results in various dose-fractionation schedules. However, the optimal dose, fractionation regimen, and the dose reference method are yet to be determined. Clinical trial s comparing SBRT and sublobar resection were planned but too few cases were enrolled to provide definitive evidence. SBRT for hepatocellular carcinoma(HCC) is a standard treatment option for patients who are ineligible for resection or radiofrequency ablation. A phase II trial for untreated non-metastatic primary HCC is ongoing in Japan which is expected to provide more supporting evidence.
立体定向体部放疗(SBRT)被定义为在短疗程治疗中,以肿瘤消融意图进行图像引导下的高剂量放射治疗的管理与实施。SBRT比三维适形放疗(3D-CRT)更有效。在针对T1N0M0非小细胞肺癌的II期JCOG0403试验中,可手术患者的3年总生存率为76%,不可手术患者为59.9%。几位作者报告了不同剂量分割方案的治疗结果。然而,最佳剂量、分割方案以及剂量参考方法仍有待确定。比较SBRT与肺叶下切除术的临床试验已在计划中,但入组病例过少,无法提供确凿证据。对于无法进行手术切除或射频消融的肝细胞癌(HCC)患者,SBRT是一种标准的治疗选择。日本正在进行一项针对未经治疗的非转移性原发性HCC的II期试验,预计将提供更多支持性证据。