立体定向体部放疗用于原发性和转移性肝肿瘤——梅奥诊所的经验
Stereotactic body radiotherapy for primary and metastatic liver tumors - the Mayo Clinic experience.
作者信息
Merrell Kenneth W, Johnson Jedediah E, Mou Benjamin, Barney Brandon M, Nelson Kathryn E, Mayo Charles S, Haddock Michael G, Hallemeier Christopher L, Olivier Kenneth R
机构信息
Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
J Radiosurg SBRT. 2016;4(2):133-144.
INTRODUCTION
To better understand the efficacy of liver SBRT we reviewed our prospectively collected institutional SBRT database.
METHODS
Between May 2008 and March 2013, 80 patients with 104 liver lesions received SBRT. The Kaplan-Meier method estimated local control (LC), overall survival (OS). Cox proportional hazards regression models identified factors associated with LC and OS.
RESULTS
The median follow-up for living patients was 38.6 months. Patients had primary (n=17) or metastatic (n=63) tumors. The median tumor size was 2.7 cm (range, 0.6-14.0). The 1 and 4 year rates of LC were 89.4% and 88%, respectively. Colorectal (CRC) metastasis was associated with lower rates of LC (p=0.013). OS at 1 and 4 years was 78% and 25%, respectively. Patients with CRC metastases had higher rates of OS (p=0.03). The occurrence of severe acute and late toxicity was 3.8% and 6.3%, respectively.
CONCLUSIONS
SBRT should be studied in prospective clinical trials compared with other liver-directed treatment modalities.
引言
为了更好地了解肝脏立体定向体部放疗（SBRT）的疗效，我们回顾了前瞻性收集的机构SBRT数据库。
方法
2008年5月至2013年3月期间，80例患有104个肝脏病灶的患者接受了SBRT治疗。采用Kaplan-Meier方法估计局部控制率（LC）、总生存率（OS）。Cox比例风险回归模型确定与LC和OS相关的因素。
结果
存活患者的中位随访时间为38.6个月。患者患有原发性（n = 17）或转移性（n = 63）肿瘤。肿瘤中位大小为2.7 cm（范围0.6 - 14.0）。1年和4年的LC率分别为89.4%和88%。结直肠癌（CRC）转移与较低的LC率相关（p = 0.013）。1年和4年的OS分别为78%和25%。CRC转移患者的OS率较高（p = 0.03）。严重急性和晚期毒性的发生率分别为3.8%和6.3%。
结论
与其他肝脏定向治疗方式相比，SBRT应在前瞻性临床试验中进行研究。
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