Oncol Res Treat. 2017;40(4):207-214. doi: 10.1159/000457129. Epub 2017 Mar 9.
We evaluated the efficacy, toxicity, and dose responses of re-irradiation with stereotactic body radiotherapy (SBRT) in patients with recurrent non- small cell lung cancer (NSCLC) after previous irradiation.
28 patients were included. Previous median radiation doses were 54 and 66 Gy. The median interval time between previous radiotherapy and SBRT was 14 months. The median follow-up time after SBRT was 9 months (range 3-93 months). To evaluate the effectiveness of SBRT, local control, overall survival, and treatment-related toxicity were reported.
SBRT doses and fractionation ranged from 60 to 30 Gy and from 3 to 8, respectively, according to previous doses, location of the recurrence, and interval time. 65% of tumor recurrences overlapped with previous treatment, while 35% of tumors recurred outside of the previous treatment. 4 patients had local progression after SBRT at their first follow-up. The Kaplan-Meier estimates of the 1- and 2-year actuarial overall survival were 71 and 42%, respectively. The mean survival following SBRT was 32.8 months, and the median survival was 21 months. No grade 3 or higher toxicities were observed.
Robotic SBRT is a tolerable treatment option with manageable toxicity which can be used with radical or palliative intent in carefully selected patients with locally recurrent tumors after previous irradiation.
我们评估了立体定向体部放疗（SBRT）再放疗在既往放疗后复发的非小细胞肺癌（NSCLC）患者中的疗效、毒性和剂量反应。
共纳入 28 例患者。既往中位放疗剂量分别为 54 和 66 Gy。SBRT 前放疗与 SBRT 之间的中位时间间隔为 14 个月。SBRT 后中位随访时间为 9 个月（3-93 个月）。为评估 SBRT 的有效性，报告了局部控制、总生存率和与治疗相关的毒性。
SBRT 剂量和分割范围分别为 60-30 Gy 和 3-8 Gy，取决于既往剂量、复发部位和间隔时间。65%的肿瘤复发与既往治疗重叠，35%的肿瘤复发于既往治疗范围之外。4 例患者在首次随访时出现 SBRT 后局部进展。1 年和 2 年的Kaplan-Meier 估计总生存率分别为 71%和 42%。SBRT 后的平均生存时间为 32.8 个月，中位生存时间为 21 个月。未观察到 3 级或更高毒性。
机器人 SBRT 是一种可耐受的治疗选择，具有可管理的毒性，可用于既往放疗后局部复发肿瘤的有选择的患者，无论根治性或姑息性放疗。
