Geng Jianhao, Shi Anhui, Yu Rong, Wu Hao, Zhu Guangying
Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Zhongguo Fei Ai Za Zhi. 2015 May;18(5):301-7. doi: 10.3779/j.issn.1009-3419.2015.05.08.
With the rapid development of technology, stereotactic radiotherapy has been widely used. In a cohort of medically operable non-small cell lung cancer patients receiving stereotactic body radiation therapy (SBRT) survival rates "potentially equivalent to those of surgery" have been reported. Removing the field flattening filter, Clinac is capable of delivering dose rates much higher than conventional linac as well as reducing the treatment time. The goals of this work were to report safety and efficacy of SBRT treatment using a flattening filter-free model for non-small cell lung cancer (NSCLC) with small lesions.
From December 2011 to December 2013, 31 NSCLC patients who were T1-2N0M0, solitary pulmonary recurrence after surgery, and stage IV with oligo metastasis were enrolled, receiving SBRT treatment (60 Gy/8 f or 48 Gy/4 f) applying a flattening filter-free model.
Compared with conventional technique, flattening filter-free model shortened the treating time with equivalent target dose and normal tissue dose. The median follow-up time is 19.4 mo. The 1-yr local control, regional control, distant control, progression free survival and overall survival rates were 96.8%, 96.8%, 83.9%, 77.4% and 96.8%. The most common side effects were radiation pneumonitis (29% grade 1, 3.2% grade 2) and chest pain (12.9% grade 1, 6.5% grade 2).
The use of flattening filter-free model in SBRT for small lesions of NSCLC patients is safe and effective. Long time follow-up and additional studies are still needed to validate our conclusions.
随着技术的快速发展，立体定向放射治疗已被广泛应用。在一组接受立体定向体部放射治疗（SBRT）的可手术非小细胞肺癌患者中，已报告生存率“可能等同于手术”。去除射野均整器后，医科达直线加速器能够提供比传统直线加速器高得多的剂量率，并减少治疗时间。本研究的目的是报告使用无均整器模式对小病灶非小细胞肺癌（NSCLC）进行SBRT治疗的安全性和有效性。
2011年12月至2013年12月，纳入31例T1-2N0M0、术后孤立性肺复发以及IV期寡转移的NSCLC患者，采用无均整器模式接受SBRT治疗（60 Gy/8次或48 Gy/4次）。
与传统技术相比，无均整器模式在靶区剂量和正常组织剂量相当的情况下缩短了治疗时间。中位随访时间为19.4个月。1年局部控制率、区域控制率、远处控制率、无进展生存率和总生存率分别为96.8%、96.8%、83.9%、77.4%和96.8%。最常见的副作用是放射性肺炎（1级29%，2级3.2%）和胸痛（1级12.9%，2级6.5%）。
在NSCLC患者小病灶的SBRT中使用无均整器模式是安全有效的。仍需要长期随访和更多研究来验证我们的结论。
