Hatayama Y, Aoki M, Kawaguchi H, Hirose K, Sato M, Akimoto H, Tanaka M, Fujioka I, Ichise K, Ono S, Takai Y
Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, and.
Curr Oncol. 2017 Aug;24(4):e285-e289. doi: 10.3747/co.24.3500. Epub 2017 Aug 31.
We evaluated the efficacy and toxicity of accelerated hypofractionated radiotherapy (ahypof-rt) for central-type small lung tumours.
Between November 2006 and January 2015, 40 patients with central-type small lung tumours underwent ahypof-rt delivered using 10 MV X-rays and a coplanar 3-field technique. The number of fractions ranged from 24 to 28, with a fraction size of 2.5-3 Gy. A total dose of 69-75 Gy to the isocentre of the planning target volume was administered to each patient. Cumulative survival and local control rates were calculated using the Kaplan-Meier method.
The 27 men and 13 women enrolled in the study had a median age of 79 years (range: 60-87 years). The tumour stage was T1a in 9 patients, T1b in 17 patients, and T2a in 14 patients, with a median size of 26.5 cm (range: 11-49 cm). The median follow-up period was 23 months. A complete response was achieved in 3 patients (7.5%), and a partial response, in 17 patients (42.5%). The overall 2-year and 3-year local control rates were 87.3% and 81.8% respectively; the 2-year and 3-year overall survival rates were 78.9% and 66.7% respectively. Grade 3 pneumonitis occurred in 3 patients; no other severe adverse events (≥grade 3) were observed in any patient.
Accelerated hypofractionated radiotherapy using a fraction size of 2.5-3 Gy was highly safe and can be a more effective treatment option than conventional radiotherapy for patients with central-type small lung tumours.
我们评估了加速分割低分割放疗(ahypof-rt)治疗中央型小肺癌的疗效和毒性。
2006年11月至2015年1月期间,40例中央型小肺癌患者接受了使用10 MV X射线和共面三野技术的ahypof-rt治疗。分割次数为24至28次,每次分割剂量为2.5 - 3 Gy。每位患者计划靶体积等中心的总剂量为69 - 75 Gy。采用Kaplan-Meier法计算累积生存率和局部控制率。
纳入研究的27例男性和13例女性患者的中位年龄为79岁(范围:60 - 87岁)。肿瘤分期为T1a的患者9例,T1b的患者17例,T2a的患者14例,中位大小为26.5 cm(范围:11 - 49 cm)。中位随访期为23个月。3例患者(7.5%)达到完全缓解,17例患者(42.5%)达到部分缓解。2年和3年的总体局部控制率分别为87.3%和81.8%;2年和3年的总生存率分别为78.9%和66.7%。3例患者发生3级肺炎;未观察到其他严重不良事件(≥3级)。
对于中央型小肺癌患者,采用2.5 - 3 Gy分割剂量的加速分割低分割放疗安全性高,且可能是比传统放疗更有效的治疗选择。