Yeo Seung-Gu
Department of Radiation Oncology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Cheonan, Republic of Korea.
Onco Targets Ther. 2017 Jul 4;10:3285-3288. doi: 10.2147/OTT.S138595. eCollection 2017.
Primary lung sarcoma (PLS) is an extremely rare, very aggressive malignancy. Surgical removal is considered the treatment of choice, and patients who have been given conventional radiotherapy have had inferior outcomes. This study is the first describing a case of PLS treated with stereotactic ablative radiotherapy (SABR), which precisely targets a small tumor with a markedly higher biologically effective dose than conventional radiotherapy. The patient was an 82-year-old man who was diagnosed with primary lung leiomyosarcoma based on radiology, pathology, and immunohistochemical examinations. The PLS was located in the right lower lobe and measured 2.5 cm. No regional nodal or distant organ metastasis was observed. He was inoperable medically. The SABR was performed using volumetric modulated arc therapy and a dose of 56 Gy in four fractions. Follow-up computed tomography 2 months after SABR revealed a complete tumor response. The toxicity was limited to mild respiratory symptoms. The patient is alive and has had no evidence of disease for 2 years. This study suggests that SABR can be a safe and effective treatment option for PLS.
原发性肺肉瘤（PLS）是一种极其罕见、侵袭性很强的恶性肿瘤。手术切除被认为是首选治疗方法，接受传统放疗的患者预后较差。本研究首次描述了一例采用立体定向消融放疗（SABR）治疗的PLS病例，该方法能精确靶向小肿瘤，其生物学有效剂量明显高于传统放疗。患者为一名82岁男性，经放射学、病理学和免疫组化检查诊断为原发性肺平滑肌肉瘤。PLS位于右下叶，大小为2.5厘米。未观察到区域淋巴结或远处器官转移。他因医学原因无法进行手术。采用容积调强弧形放疗进行SABR，分4次给予56 Gy的剂量。SABR后2个月的随访计算机断层扫描显示肿瘤完全缓解。毒性仅限于轻度呼吸道症状。患者存活，2年来无疾病证据。本研究表明，SABR可能是PLS的一种安全有效的治疗选择。
