早期肺癌的立体定向放射治疗：循证方法与未来方向。
Stereotactic radiotherapy for early lung cancer: Evidence-based approach and future directions.
作者信息
Chehade Samer, Palma David A
机构信息
Faculty of Medicine, University of Western Ontario, London, ON, Canada.
Faculty of Medicine, University of Western Ontario, London, ON, Canada ; Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada.
出版信息
Rep Pract Oncol Radiother. 2015 Nov-Dec;20(6):403-10. doi: 10.1016/j.rpor.2014.11.007. Epub 2014 Dec 12.
AIM
To review key studies evaluating stereotactic radiotherapy in the setting of early-stage non-small cell lung cancer (NSCLC) for inoperable or high-risk patients, and discuss areas of ongoing research and clinical trials.
BACKGROUND
The use of stereotactic radiotherapy for the treatment of early stage non-small cell lung cancer (NSCLC) has increased rapidly over the past decade. Numerous studies have reported outcomes for patients treated with SBRT who are unfit for surgical resection, or at high risk of surgical complications.
MATERIALS AND METHODS
A narrative review.
RESULTS
The preponderance of evidence suggests that SBRT is associated with excellent local control (∼90% at 3 years) and a favorable toxicity profile. In patients with higher operative risks, such as the elderly and patients with severe COPD, SBRT may provide a less-toxic treatment than surgery with similar oncologic outcomes. Ongoing studies are evaluating the use of SBRT for locally advanced or oligometastatic NSCLC.
CONCLUSIONS
A large body of evidence now exists to support the use of SBRT for early-stage NSCLC. Decisions regarding the optimal choice of treatment should be individualized, and made in the context of a multidisciplinary team.
目的
回顾评估立体定向放射治疗用于不可手术或高危早期非小细胞肺癌（NSCLC）患者的关键研究，并讨论正在进行的研究和临床试验领域。
背景
在过去十年中，立体定向放射治疗用于治疗早期非小细胞肺癌（NSCLC）的应用迅速增加。许多研究报告了接受立体定向体部放疗（SBRT）但不适合手术切除或手术并发症风险高的患者的治疗结果。
材料与方法
叙述性综述。
结果
大量证据表明，SBRT具有出色的局部控制率（3年时约为90%）和良好的毒性特征。在手术风险较高的患者中，如老年人和重度慢性阻塞性肺疾病（COPD）患者，SBRT可能比手术提供毒性更低的治疗，且肿瘤学结局相似。正在进行的研究正在评估SBRT用于局部晚期或寡转移NSCLC的情况。
结论
现在有大量证据支持将SBRT用于早期NSCLC。关于最佳治疗选择的决策应个体化，并在多学科团队的背景下做出。
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