Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY; Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY.
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY; Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY.
Clin Lung Cancer. 2018 Mar;19(2):e235-e240. doi: 10.1016/j.cllc.2017.10.010. Epub 2017 Oct 28.
To compare the clinical outcomes of patients with early-stage non-small-cell lung cancer (NSCLC) who had undergone either single-fraction (SF) or three-fraction (TF) stereotactic body radiation therapy (SBRT) at a single institution during over 8-year period.
Patients with peripherally located early-stage NSCLC who had undergone SBRT from February 2007 to November 2015 were included in the present study. SBRT was delivered without heterogeneity correction. Data were retrospectively reviewed and collected in an institutional review board-approved database. R software (version 3.3.2) was used for statistical analysis.
Of 159 total lung tumors, 65 lesions received 30 Gy (median, 30 Gy) in 1 fraction, and 94 lesions received 48 to 60 Gy (median, 60 Gy) in 3 fractions. Patients with a Karnofsky performance status < 80 were more common in the SF-SBRT cohort (P = .050). After a median follow-up of 22.2 and 26.2 months for the SF-SBRT and TF-SBRT cohorts, respectively (P = .29), no statistically significant difference was found in overall survival (P = .86), progression-free survival (P = .95), local failure (P = .95), nodal failure (P = .91), and distant failure (P = .49) at 24 months. At 1 and 2 years, the overall survival rates were 86.1% and 63.2% for the SF-SBRT cohort and 80.8% and 61.6% for the TF-SBRT cohort, respectively. At 1 and 2 years, the local control rates were 95.1% and 87.8% for the SF-SBRT cohort and 92.7% and 86.2% for the TF-SBRT cohort, respectively. Both regimens were well tolerated.
Despite more patients with poor performance status in the SF-SBRT cohort, the SF- and TF-SBRT regimens showed no differences in clinical outcomes. SF-SBRT is now our standard approach.
比较单剂量（SF）和三剂量（TF）立体定向体放射治疗（SBRT）治疗单中心 8 年以上早期非小细胞肺癌（NSCLC）患者的临床结果。
本研究纳入了 2007 年 2 月至 2015 年 11 月接受 SBRT 的外周性早期 NSCLC 患者。SBRT 不进行不均匀校正。数据通过机构审查委员会批准的数据库进行回顾性分析和收集。使用 R 软件（版本 3.3.2）进行统计分析。
159 个肺部肿瘤中，65 个病灶接受 30 Gy（中位数 30 Gy）单次分割治疗，94 个病灶接受 48 至 60 Gy（中位数 60 Gy）3 次分割治疗。SF-SBRT 组中卡氏功能状态评分<80 的患者更为常见（P=0.050）。SF-SBRT 和 TF-SBRT 组的中位随访时间分别为 22.2 和 26.2 个月（P=0.29），24 个月时总体生存率（P=0.86）、无进展生存率（P=0.95）、局部失败率（P=0.95）、淋巴结失败率（P=0.91）和远处失败率（P=0.49）无统计学差异。SF-SBRT 组 1 年和 2 年的总生存率分别为 86.1%和 63.2%，TF-SBRT 组分别为 80.8%和 61.6%。SF-SBRT 组 1 年和 2 年的局部控制率分别为 95.1%和 87.8%，TF-SBRT 组分别为 92.7%和 86.2%。两种方案均耐受良好。
尽管 SF-SBRT 组中患者的表现状态较差，但 SF-SBRT 和 TF-SBRT 方案在临床结果方面没有差异。SF-SBRT 现在是我们的标准治疗方法。
