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立体定向体部放疗治疗Ⅰ期非小细胞肺癌时实变与最大肿瘤直径比值与预后的关系

Relationship between the consolidation to maximum tumor diameter ratio and outcomes following stereotactic body radiotherapy for stage I non-small-cell lung cancer.

作者信息

Tsurugai Yuichiro, Kozuka Takuyo, Ishizuka Naoki, Oguchi Masahiko

机构信息

Radiation Oncology Department, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

Radiation Oncology Department, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

出版信息

Lung Cancer. 2016 Feb;92:47-52. doi: 10.1016/j.lungcan.2015.12.003. Epub 2015 Dec 17.

Abstract

PURPOSE

We investigated whether the ratio of the maximum diameter of consolidation to the maximum tumor diameter (consolidation/tumor ratio, CTR) predicted the outcomes of patients who received stereotactic body radiotherapy (SBRT) for non-small-cell lung cancer (NSCLC).

METHODS AND MATERIALS

Between 2005 and 2014, 237 patients with stage I NSCLC were treated with SBRT, receiving 48 Gy in 4 fractions. Of these patients, those who received pretreatment thin section computed tomography were selected for this analysis. The relationship between the CTR and outcomes (local control [LC], disease-free survival [DFS], and overall survival [OS]) was analyzed.

RESULTS

One hundred and fifty-five patients were eligible. The median follow-up time was 34.7 months (range, 1.2-109.8). In the CTR<0.5, CTR 0.5-<1, and CTR=1 groups, 0, 2, and 12 patients experienced local recurrences, respectively. Three-year DFS and OS rates were 96.7% and 87.5% in the CTR<0.5 group, 85.1% and 81.1% in the CTR 0.5-<1 group, and 63.3% and 70.1% in the CTR=1 group, respectively. In multivariate analysis, CTR was the only significant predictor of DFS (P<0.001).

CONCLUSION

The CTR effectively predicts DFS after SBRT in NSCLC patients.

摘要

目的

我们研究了实性变最大直径与肿瘤最大直径之比(实性变/肿瘤比,CTR)是否能预测接受立体定向体部放疗(SBRT)的非小细胞肺癌(NSCLC)患者的预后。

方法和材料

2005年至2014年间,237例I期NSCLC患者接受了SBRT治疗,分4次给予48 Gy。在这些患者中,选择接受过治疗前薄层计算机断层扫描的患者进行本分析。分析CTR与预后(局部控制[LC]、无病生存[DFS]和总生存[OS])之间的关系。

结果

155例患者符合条件。中位随访时间为34.7个月(范围1.2 - 109.8个月)。在CTR<0.5、CTR 0.5 - <1和CTR = 1组中,分别有0、2和12例患者出现局部复发。CTR<0.5组的3年DFS和OS率分别为96.7%和87.5%,CTR 0.5 - <1组为85.1%和81.1%,CTR = 1组为63.3%和70.1%。多因素分析中,CTR是DFS的唯一显著预测因素(P<0.001)。

结论

CTR能有效预测NSCLC患者SBRT后的DFS。

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