立体定向体部放疗用于特发性间质性肺炎的肺癌患者

Stereotactic body radiotherapy for lung cancer patients with idiopathic interstitial pneumonias.

作者信息

Tsurugai Yuichiro, Takeda Atsuya, Sanuki Naoko, Enomoto Tatsuji, Kaneko Takeshi, Hara Yu, Mizuno Tomikazu, Saeki Noriyuki, Aoki Yousuke, Oku Yohei, Akiba Takeshi, Kunieda Etsuo

机构信息

Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Japan.

Department of Respiratory Medicine, Ofuna Chuo Hospital, Kamakura, Japan.

出版信息

Radiother Oncol. 2017 Nov;125(2):310-316. doi: 10.1016/j.radonc.2017.08.026. Epub 2017 Sep 14.

DOI:10.1016/j.radonc.2017.08.026

PMID:28919004

Abstract

PURPOSE

To compare toxicity and survival after stereotactic body radiotherapy (SBRT) between lung cancer patients with or without idiopathic interstitial pneumonias (IIPs), and to investigate the potential value of SBRT for the patients.

METHODS

Among lung cancer patients receiving SBRT between 2005 and 2016, we evaluated those treated with a total dose of 40-60Gy in five fractions with curative intent who either were staged as cT1-4N0M0 or experienced postoperative isolated local recurrence. We analyzed the incidence of radiation pneumonitis (RP) in all patients and local recurrence and overall survival (OS) in T1a-2a patients.

RESULTS

A total of 508 patients were eligible, including 42 with IIPs. The median follow-up was 32.3 (6.0-120.9) months. Significantly more patients with IIPs had grade ≥3RP than did those without IIPs (12% vs. 3%, p=0.009). The 2-year local recurrence rate was low in both groups (3.4% vs. 5.6%, p=0.38). The 2-year OS rate was significantly lower in the patients with IIPs (42.2% vs. 80.9%, p<0.001), although death from lung cancer was comparable (p=0.74).

CONCLUSION

SBRT achieved excellent local control with acceptable pulmonary toxicity in lung cancer patients with IIPs. SBRT can be a reasonable option for early lung cancer patients with IIPs.

摘要

目的

比较患有或不患有特发性间质性肺炎（IIP）的肺癌患者接受立体定向体部放疗（SBRT）后的毒性反应和生存率，并探讨SBRT对这些患者的潜在价值。

方法

在2005年至2016年间接受SBRT的肺癌患者中，我们评估了那些接受总剂量40 - 60Gy、分五次给予且具有治愈意图的患者，这些患者要么分期为cT1 - 4N0M0，要么经历了术后孤立性局部复发。我们分析了所有患者放射性肺炎（RP）的发生率以及T1a - 2a患者的局部复发率和总生存率（OS）。

结果

共有508例患者符合条件，其中42例患有IIP。中位随访时间为32.3（6.0 - 120.9）个月。患有IIP的患者中≥3级RP的发生率显著高于无IIP的患者（12%对3%，p = 0.009）。两组的2年局部复发率均较低（3.4%对5.6%，p = 0.38）。患有IIP的患者2年OS率显著较低（42.2%对80.9%，p < 0.001），尽管因肺癌死亡的情况相当（p = 0.74）。