Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA.
Department of Thoracic Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Semin Oncol. 2018 Aug;45(4):210-219. doi: 10.1053/j.seminoncol.2018.06.002. Epub 2018 Jul 1.
Early-stage non-small cell lung cancer (NSCLC) is on the rise due to the implementation of screening guidelines for patients at risk for developing lung cancer. It is anticipated that as the US population continues to age, there will be a higher percentage of medically inoperable early-stage lung cancer patients. For this reason, noninvasive ablative therapies are necessary. Stereotactic body radiation therapy (SBRT) is an effective modality in addressing early-stage NSCLC. SBRT consists of high-dose radiation delivered over 3-5 treatments. Several randomized trials comparing surgery to SBRT in early-stage operable patients have unfortunately closed early due to poor accrual. However, a recent pooled analysis from 2 randomized trials (StereoTActic Radiotherapy and Radiosurgery Or Surgery for operable Early-stage non-small cell Lung cancer) comparing surgery to SBRT did show comparable local control and overall survival rates between surgery and SBRT, offering a very effective, noninvasive modality for older adult patients with early-stage NSCLC. In this review, we summarize the role of SBRT in early-stage NSCLC, in particularly applied to the older adult population.
由于对有肺癌发病风险的患者实施了筛查指南，早期非小细胞肺癌（NSCLC）的发病率正在上升。预计随着美国人口老龄化，将有更高比例的不能手术的早期肺癌患者。出于这个原因，非侵入性的消融治疗是必要的。立体定向体部放射治疗（SBRT）是治疗早期 NSCLC 的有效方法。SBRT 由 3-5 次治疗中给予的高剂量辐射组成。几项比较手术和 SBRT 治疗早期可手术患者的随机试验不幸因入组困难而提前关闭。然而，最近来自 2 项随机试验（立体定向放射治疗和放射外科或手术治疗可手术的早期非小细胞肺癌）的荟萃分析比较了手术和 SBRT，结果显示手术和 SBRT 之间局部控制和总生存率相当，为早期 NSCLC 的老年患者提供了一种非常有效、非侵入性的治疗方法。在这篇综述中，我们总结了 SBRT 在早期 NSCLC 中的作用，特别是在老年人群中的应用。
