Maranzano Ernesto, Draghini Lorena, Rossi Romina, Casale Michelina, Trippa Fabio
Radiotherapy Oncology Center, S. Maria Hospital, 1- 05100 Terni, Italy.
J Radiosurg SBRT. 2013;2(3):243-250.
This study aimed to analyze the outcome of low and medium doses of hypofractionated stereotactic body radiotherapy (SBRT) in early stage lung cancer.
Thirty-five early stage lung cancer patients were treated with SBRT. Initially, SBRT was administered with a low dose of 5 x 8Gy in all cases. Subsequently, a medium dose of 5 x 10Gy for peripherally located lesions was given, continuing to prescribe 5 x 8Gy in centrally located ones. Study endpoints were local control (LC), LC duration, survival and toxicity.
Patients had a good performance status, and T1-2 stage cancer. The SBRT doses of 5 x 8Gy and 5 x 10Gy were administered to 57% and 43% of patients, respectively. At first evaluation after SBRT, local control was obtained in all cases but only 15 (43%) had a complete response. Median duration of LC was 41 months and there was a trend in favor of 5 x 10Gy with respect to 5 x 8Gy in 2- and 3-year LC rates (93% and 69%, versus 60% and 50%, = 0.1). Four of the 15 (27%) complete responders had local relapse after a quite long median time of 31.5 months. Median overall survival was 40 months. No examined variables (i.e., dose, volume, T stage, and site) significantly conditioned LC, duration of LC, failure rate and survival. Both SBRT schedules were well tolerated.
Outcome of low and medium SBRT doses in terms of LC, duration of LC, patterns of failure and survival was suboptimal compared with recently reported results of SBRT in early stage lung cancer patients.
本研究旨在分析低剂量和中等剂量的短疗程立体定向体部放疗（SBRT）用于早期肺癌的疗效。
35例早期肺癌患者接受了SBRT治疗。所有患者最初均接受5×8Gy的低剂量SBRT。随后，对于周围型病变给予5×10Gy的中等剂量，对于中央型病变则继续给予5×8Gy。研究终点为局部控制（LC）、LC持续时间、生存率和毒性。
患者一般状况良好，为T1-2期癌症。分别有57%和43%的患者接受了5×8Gy和5×10Gy的SBRT剂量。SBRT后首次评估时，所有病例均获得局部控制，但仅15例（43%）完全缓解。LC的中位持续时间为41个月，在2年和3年LC率方面，5×10Gy组相对于5×8Gy组有更好的趋势（93%和69%，对比60%和50%，P = 0.1）。15例完全缓解者中有4例（27%）在相当长的中位时间31.5个月后出现局部复发。中位总生存期为40个月。所检查的变量（即剂量、体积、T分期和部位）均未显著影响LC、LC持续时间、失败率和生存率。两种SBRT方案耐受性均良好。
与近期报道的早期肺癌患者SBRT结果相比，低剂量和中等剂量SBRT在LC、LC持续时间、失败模式和生存率方面的疗效欠佳。
