针对部分Ⅰ期非小细胞肺癌（NSCLC）患者采用低剂量立体定向体部放疗（SBRT）
Stereotactic Body Radiotherapy (SBRT) with Lower Doses for Selected Patients with Stage I Non-small-cell Lung Cancer (NSCLC).
作者信息
Janssen Stefan, Kaesmann Lukas, Rudat Volker, Rades Dirk
机构信息
Department of Radiation Oncology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
出版信息
Lung. 2016 Apr;194(2):291-4. doi: 10.1007/s00408-016-9849-4. Epub 2016 Feb 3.
SBRT is very effective for stage I NSCLC. Biologically effective doses (BED) >100 Gy are recommended. Elderly patients and those with a limited performance status may not tolerate these high doses. This study investigated the outcomes after lower dose SBRT (BED < 90 Gy) in 46 patients with stage I NSCLC, who were aged ≥70 years or in reduced general condition. Local control rates at 1, 2, and 3 years were 100, 95, and 95 %, respectively. Rates of freedom from distant progression were 83, 63, and 54 %, and survival rates were 77, 57, and 36 %, respectively. Seventeen patients died during the follow-up, 11 (65 %) from distant progression of NSCLC, and six (35 %) from non-malignant causes. No patient developed radiation-induced pneumonitis. Thus, SBRT with BED <90 Gy resulted in excellent local control and appears to be a reasonable option for stage I NSCLC in elderly patients and those with a poor performance status.
立体定向体部放疗（SBRT）对Ⅰ期非小细胞肺癌（NSCLC）非常有效。推荐生物等效剂量（BED）>100 Gy。老年患者和身体状况有限的患者可能无法耐受这些高剂量。本研究调查了46例年龄≥70岁或一般状况较差的Ⅰ期NSCLC患者接受低剂量SBRT（BED<90 Gy）后的结果。1年、2年和3年的局部控制率分别为100%、95%和95%。无远处进展生存率分别为83%、63%和54%，生存率分别为77%、57%和36%。17例患者在随访期间死亡，11例（65%）死于NSCLC远处进展，6例（35%）死于非恶性原因。无患者发生放射性肺炎。因此，BED<90 Gy的SBRT可实现良好的局部控制，对于老年和身体状况较差的Ⅰ期NSCLC患者似乎是一个合理的选择。
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