National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba-shi, Japan; Department of Radiology, The University of Tokyo Hospital, Japan; Department of Radiotherapy, Mitsui Memorial Hospital, Japan.
National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba-shi, Japan.
Radiother Oncol. 2017 Oct;125(1):31-35. doi: 10.1016/j.radonc.2017.07.022. Epub 2017 Aug 4.
To investigate carbon-ion radiotherapy (CIRT) for in-field recurrence of stage I non-small cell lung cancer (NSCLC) initially treated with CIRT.
From January 2007 to March 2014, patients initially treated for stage I NSCLC with CIRT and relapsed in-field were candidates. Overall survival (OS) rate, local control (LC) rate, progressive free survival (PFS) rate, dose to the lungs and skin, and adverse effects were analyzed.
Twenty-nine patients were eligible. Median age at re-irradiation was 74years (range 53-90). Median observation period from the first day of re-irradiation was 29months (4-88months). Median prescribed dose was 46.0Gy (RBE) as initial treatment and 66.0Gy (RBE) in 12 fractions as re-irradiation. Two-year OS, LC, and PFS rates after re-irradiation were 69.0% (95% CI: 50.3-83.0), 66.9% (95% CI: 47.5-81.9), and 51.7% (95% CI: 34.1-68.9). Median skin maximum dose was 53.8Gy (RBE) (range 4.4-103.1) and median of mean lung dose was 7.3Gy (RBE) (range 2.6-14.0). There were no severer than grade 2 adverse effects except one (3.4%) grade 3 bacterial pneumonia, which was not considered radiation-induced.
CIRT for stage I NSCLC local recurrence is an acceptable definitive re-treatment.
研究碳离子放疗（CIRT）治疗初始采用 CIRT 治疗的 I 期非小细胞肺癌（NSCLC）局部复发的疗效。
自 2007 年 1 月至 2014 年 3 月，选择初始接受 CIRT 治疗并局部复发的 I 期 NSCLC 患者作为研究对象。分析总生存（OS）率、局部控制（LC）率、无进展生存（PFS）率、肺和皮肤剂量以及不良反应。
共有 29 例患者符合条件。再次放疗时的中位年龄为 74 岁（范围 53-90 岁）。从再次放疗的第一天开始中位观察时间为 29 个月（4-88 个月）。中位初始治疗剂量为 46.0Gy（RBE），12 次分割再次放疗剂量为 66.0Gy（RBE）。再次放疗后 2 年的 OS、LC 和 PFS 率分别为 69.0%（95%CI：50.3-83.0）、66.9%（95%CI：47.5-81.9）和 51.7%（95%CI：34.1-68.9）。皮肤最大剂量的中位值为 53.8Gy（RBE）（范围 4.4-103.1），平均肺剂量的中位值为 7.3Gy（RBE）（范围 2.6-14.0）。除 1 例（3.4%）为 3 级细菌性肺炎外，无其他严重不良反应，且该肺炎不考虑与放疗相关。
CIRT 治疗 I 期 NSCLC 局部复发是一种可接受的确定性再治疗方法。
