Song Sanghyuk, Chang Ji Hyun, Kim Hak Jae, Kim Yeon Sil, Kim Jin Hee, Ahn Yong Chan, Kim Jae-Sung, Song Si Yeol, Moon Sung Ho, Cho Moon June, Youn Seon Min
Department of Radiation Oncology, Samsung Medical Center, Seoul, Korea.
Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Korea.
Cancer Res Treat. 2017 Jul;49(3):688-694. doi: 10.4143/crt.2016.219. Epub 2016 Oct 31.
Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea.
We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants' opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey.
SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule.
The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.
立体定向消融放疗（SABR）是一种用于早期非小细胞肺癌（NSCLC）的有效新兴技术。我们调查了韩国SABR治疗早期NSCLC的当前实践情况。
我们通过向韩国放射肿瘤学会所有获得委员会认证的成员发送电子邮件，对NSCLC的SABR进行了全国性调查。该调查包括23个聚焦于SABR技术方面的问题以及18个寻求参与者对SABR用于早期NSCLC特定临床场景意见的问题。总体而言，韩国85家专科医院中的61家（71.8%）的79名放射肿瘤学家回复了该调查。
33家机构（54%）使用SABR治疗NSCLC。在技术方面，最常用的计划方法是旋转调强技术（59%）和静态调强技术（49%）。呼吸运动通过门控（54%）或腹部压迫（51%）进行管理，并且86%的计划扫描使用四维计算机断层扫描获得。在临床场景中，对于外周型T1 NSCLC最常选择的分割方案是4次分割给予60 Gy。对于中央型肿瘤和T2 NSCLC，肿瘤学家倾向于避免使用SABR进行放疗，并延长分割方案。
我们的调查结果表明，SABR在韩国越来越多地用于治疗NSCLC。然而，各机构之间SABR用于早期NSCLC的技术方案和分割方案存在很大差异。在开展全国性、多中心、随机研究之前，SABR的标准化是必要的。
