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结直肠癌寡转移的大分割立体定向放射治疗后的结果

Outcomes after hypofractionated stereotactic radiotherapy for colorectal cancer oligometastases.

作者信息

Yu Jing, Li Ning, Tang Yu, Wang Xin, Tang Yuan, Wang Shu-Lian, Song Yong-Wen, Liu Yue-Ping, Li Ye-Xiong, Jin Jing

机构信息

Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

J Surg Oncol. 2019 Mar;119(4):532-538. doi: 10.1002/jso.25361. Epub 2019 Jan 4.

DOI:10.1002/jso.25361
PMID:30609038
Abstract

BACKGROUND AND OBJECTIVES

To assess the efficacy and the effect of biologic effective dose (BED) on outcomes treated by hypofractionated stereotactic radiotherapy for colorectal cancer (CRC) oligometastases.

METHODS

Patients with CRC oligometastases treated at our hospital between 2009 and 2016 were included. The relationship between BED and risk of local recurrence was assessed. Recursive partitioning analysis (RPA) was used to evaluate the effect of BED on outcomes.

RESULTS

A total of 48 patients were included in this study. Median follow-up time of surviving patient was 15 months (range, 3-82 months). The 1-year local control rate was 85%. The risk of local recurrence decreased sharply when BED was >90 Gy . RPA showed BED of 100 Gy was the appropriate dose for recurrence risk stratification. BED ≥ 100 Gy was significantly better than BED < 100 Gy for achieving 1-year local control (94.4% vs 63.2%; P = 0.022) and 1-year OS (100% vs 73.4%; P = 0.028). One patient who received long-term antiangiogenic treatment died of massive intestinal hemorrhage; no other grade 3 or above early or late events were observed.

CONCLUSIONS

Hypofractionated stereotactic radiotherapy provides favorable outcomes with acceptable toxicities in CRC oligometastases. BED ≥ 100 Gy is associated with better outcomes.

摘要

背景与目的

评估生物等效剂量(BED)对结直肠癌(CRC)寡转移灶进行大分割立体定向放射治疗的疗效及对治疗结果的影响。

方法

纳入2009年至2016年在我院接受治疗的CRC寡转移患者。评估BED与局部复发风险之间的关系。采用递归划分分析(RPA)评估BED对治疗结果的影响。

结果

本研究共纳入48例患者。存活患者的中位随访时间为15个月(范围3 - 82个月)。1年局部控制率为85%。当BED>90 Gy时,局部复发风险急剧下降。RPA显示100 Gy的BED是复发风险分层的合适剂量。BED≥100 Gy在实现1年局部控制(94.4%对63.2%;P = 0.022)和1年总生存期(100%对73.4%;P = 0.028)方面显著优于BED<100 Gy。1例接受长期抗血管生成治疗的患者死于大量肠出血;未观察到其他3级或以上的早期或晚期事件。

结论

大分割立体定向放射治疗在CRC寡转移灶中提供了良好的治疗结果且毒性可接受。BED≥100 Gy与更好的治疗结果相关。

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