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自适应调强放疗在一名患有间质性肺疾病的患者中用于治疗化疗难治性小细胞肺癌的应用。

The use of adaptive intensity-modulated radiotherapy in the treatment of small-cell carcinoma lung refractory to chemotherapy in a patient with preexisting interstitial lung disease.

作者信息

Tandon Sarthak, Gairola Munish, Pal Manoj, Aggarwal Archana, Sharma Kanika, Karimi Ahmad Masroor, Mandal Avik, Goyal Rajiv, Batra Ullas, Kaur Inderjit

机构信息

Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.

Department of Pulmonary Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.

出版信息

Lung India. 2018 Jan-Feb;35(1):54-57. doi: 10.4103/lungindia.lungindia_93_17.

DOI:10.4103/lungindia.lungindia_93_17
PMID:29319036
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5760870/
Abstract

This is a case report of a 60-year-old diabetic, hypertensive male with a good performance status and a history of bilateral interstitial lung disease with a left upper lobe lung mass diagnosed to be a Stage IIB mixed small-cell/squamous cell carcinoma which was refractory to carboplatin- and etoposide-based chemotherapy. The patient was then taken up for adaptive intensity-modulated radiotherapy with tighter margin under image guidance with a mid-treatment replanning done at 25#. Acute toxicities were assessed weekly and showed no Grade 3 or more reactions. Pulmonary function test showed no detrimental changes during or after radiation. Response assessment at 12 and 20 weeks showed a partial response with decrease in metabolic activity on serial scans.

摘要

这是一例60岁男性糖尿病、高血压患者的病例报告，其身体状况良好，有双侧间质性肺病病史，左肺上叶有一肿块，诊断为IIB期混合性小细胞/鳞状细胞癌，对基于卡铂和依托泊苷的化疗耐药。随后，该患者在图像引导下接受了自适应调强放疗， margins更窄，并在第25次治疗时进行了中期重新计划。每周评估急性毒性，未发现3级或更严重的反应。肺功能测试显示放疗期间及放疗后无有害变化。在第12周和第20周的疗效评估显示部分缓解，连续扫描显示代谢活性降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/3a28cd674d6d/LI-35-54-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/6390439aab59/LI-35-54-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/c272e0444b2c/LI-35-54-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/3a28cd674d6d/LI-35-54-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/6390439aab59/LI-35-54-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/c272e0444b2c/LI-35-54-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a61/5760870/3a28cd674d6d/LI-35-54-g006.jpg

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2
Impact of pretreatment interstitial lung disease on radiation pneumonitis and survival after stereotactic body radiation therapy for lung cancer.预处理间质性肺病对肺癌立体定向体部放射治疗后放射性肺炎和生存的影响。
J Thorac Oncol. 2015 Jan;10(1):116-25. doi: 10.1097/JTO.0000000000000359.
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Radiotherapy for thoracic tumors: association between subclinical interstitial lung disease and fatal radiation pneumonitis.
胸部肿瘤放疗：亚临床间质性肺病与致命性放射性肺炎之间的关联
Int J Clin Oncol. 2015 Feb;20(1):45-52. doi: 10.1007/s10147-014-0679-1. Epub 2014 Mar 11.
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A nomogram to predict radiation pneumonitis, derived from a combined analysis of RTOG 9311 and institutional data.一个用于预测放射性肺炎的列线图，源自对RTOG 9311和机构数据的综合分析。
Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):985-92. doi: 10.1016/j.ijrobp.2007.04.077. Epub 2007 Aug 6.
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