医学上无法手术的I期非小细胞肺癌：最佳实践与长期结局
Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes.
作者信息
Choi J Isabelle
机构信息
Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA.
出版信息
Transl Lung Cancer Res. 2019 Feb;8(1):32-47. doi: 10.21037/tlcr.2018.06.11.
Abstract
Early-stage non-small cell lung cancer (ES-NSCLC) currently represents a minority of all NSCLC diagnoses but, with ongoing refinement and improvement of treatment approaches, is a group with increasing likelihood of long-term disease control and survival. A significant proportion of this population will not be optimal candidates for definitive surgical resection due to tumor characteristics, patient frailty, or comorbid status. The clinical evidence to support the use of stereotactic body radiation therapy (SBRT) in patients with medically inoperable stage I NSCLC is growing as long-term data are obtained. In this review, initial workup, SBRT delivery considerations, recent trial data, and post-treatment surveillance of this population are discussed.
摘要
早期非小细胞肺癌（ES-NSCLC）目前在所有NSCLC诊断病例中占少数，但随着治疗方法的不断完善和改进，这一群体实现长期疾病控制和生存的可能性越来越大。由于肿瘤特征、患者身体虚弱或合并症状态，相当一部分这类患者并非确定性手术切除的最佳候选人。随着长期数据的获得，支持在医学上无法手术的I期NSCLC患者中使用立体定向体部放射治疗（SBRT）的临床证据正在增加。在本综述中，讨论了该人群的初始检查、SBRT实施注意事项、近期试验数据以及治疗后监测。
相似文献
1
Medically inoperable stage I non-small cell lung cancer: best practices and long-term outcomes.医学上无法手术的I期非小细胞肺癌：最佳实践与长期结局
Transl Lung Cancer Res. 2019 Feb;8(1):32-47. doi: 10.21037/tlcr.2018.06.11.
2
Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.Ⅰ期和Ⅱ期非小细胞肺癌的治疗：肺癌的诊断和管理，第 3 版：美国胸科医师学会循证临床实践指南。
Chest. 2013 May;143(5 Suppl):e278S-e313S. doi: 10.1378/chest.12-2359.
3
Five-year Long-term Outcomes of Stereotactic Body Radiation Therapy for Operable Versus Medically Inoperable Stage I Non-small-cell Lung Cancer: Analysis by Operability, Fractionation Regimen, Tumor Size, and Tumor Location.立体定向体部放疗治疗可手术与不可手术Ⅰ期非小细胞肺癌的 5 年长期疗效：可手术性、分割方案、肿瘤大小和肿瘤部位分析。
Clin Lung Cancer. 2019 Jan;20(1):e63-e71. doi: 10.1016/j.cllc.2018.09.004. Epub 2018 Sep 20.
4
Stereotactic body radiation therapy versus no treatment for early stage non-small cell lung cancer in medically inoperable elderly patients: A National Cancer Data Base analysis.立体定向体部放疗与非治疗在不能手术的老年早期非小细胞肺癌患者中的比较：国家癌症数据库分析。
Cancer. 2015 Dec 1;121(23):4222-30. doi: 10.1002/cncr.29640. Epub 2015 Sep 8.
5
Long-term outcomes of stereotactic body radiation therapy (SBRT) with fiducial tracking for inoperable stage I non-small cell lung cancer (NSCLC).针对无法手术的I期非小细胞肺癌（NSCLC），采用基准跟踪的立体定向体部放射治疗（SBRT）的长期结果。
J Radiat Oncol. 2016;5(4):379-387. doi: 10.1007/s13566-016-0273-4. Epub 2016 Aug 20.
6
Stereotactic body radiation therapy (SBRT) for early-stage lung cancer in the elderly.立体定向体部放射治疗（SBRT）治疗老年早期肺癌。
Semin Oncol. 2018 Aug;45(4):210-219. doi: 10.1053/j.seminoncol.2018.06.002. Epub 2018 Jul 1.
7
Stereotactic radiotherapy for early stage non-small cell lung cancer: current standards and ongoing research.早期非小细胞肺癌的立体定向放射治疗：当前标准与正在进行的研究。
Transl Lung Cancer Res. 2021 Apr;10(4):1930-1949. doi: 10.21037/tlcr-20-860.
8
Improved survival with stereotactic ablative radiotherapy (SABR) over lobectomy for early stage non-small cell lung cancer (NSCLC): addressing the fallout of disruptive randomized data.立体定向消融放疗（SABR）较肺叶切除术治疗早期非小细胞肺癌（NSCLC）可提高生存率：解决突破性随机数据的影响。
Ann Transl Med. 2015 Jul;3(11):149. doi: 10.3978/j.issn.2305-5839.2015.06.15.
9
Stereotactic Ablative Radiotherapy as an Alternative to Lobectomy in Patients With Medically Operable Stage I NSCLC: A Retrospective, Multicenter Analysis.立体定向消融放疗作为可手术治疗的 I 期非小细胞肺癌患者肺叶切除术的替代治疗：一项回顾性、多中心分析。
Clin Lung Cancer. 2019 Jan;20(1):e53-e61. doi: 10.1016/j.cllc.2018.09.003. Epub 2018 Sep 8.
10
Radiotherapy With Curative Intent in Patients With Early-stage, Medically Inoperable, Non-Small-cell Lung Cancer: A Systematic Review.早期、医学上无法手术的非小细胞肺癌患者的根治性放疗：一项系统评价
Clin Lung Cancer. 2017 Mar;18(2):105-121.e5. doi: 10.1016/j.cllc.2016.10.008. Epub 2016 Oct 27.
引用本文的文献
1
Impact of diabetes on stage I lung cancer treatment patterns and prognosis in older adults: A population-based cohort study.糖尿病对老年人I期肺癌治疗模式和预后的影响：一项基于人群的队列研究。
Heliyon. 2023 Jul 5;9(7):e17969. doi: 10.1016/j.heliyon.2023.e17969. eCollection 2023 Jul.
2
Cost-effectiveness of stereotactic body radiotherapy versus conventional radiotherapy for the treatment of surgically ineligible stage I non-small cell lung cancer in the Brazilian public health system.在巴西公共卫生系统中，立体定向体部放疗与传统放疗治疗手术不可行的I期非小细胞肺癌的成本效益分析
Lancet Reg Health Am. 2022 Jul 25;14:100329. doi: 10.1016/j.lana.2022.100329. eCollection 2022 Oct.
3
Knowing the Bad: Adverse Event-Informed, High-Risk, Early-Stage Non-Small Cell Lung Cancer Treatment Options.了解不良情况：基于不良事件信息的、高风险、早期非小细胞肺癌的治疗选择。
Ann Am Thorac Soc. 2022 Dec;19(12):1975-1976. doi: 10.1513/AnnalsATS.202209-756ED.
4
Dendrobium officinalis inhibited tumor growth in non-small cell lung cancer.铁皮石斛抑制非小细胞肺癌的肿瘤生长。
Transl Cancer Res. 2020 Apr;9(4):2683-2691. doi: 10.21037/tcr.2020.02.79.
5
Prognostic utility of pretreatment neutrophil-lymphocyte ratio in survival outcomes in localized non-small cell lung cancer patients treated with stereotactic body radiotherapy: Selection of an ideal clinical cutoff point.立体定向体部放疗治疗的局限性非小细胞肺癌患者中，治疗前中性粒细胞与淋巴细胞比值对生存结果的预后效用：理想临床切点的选择。
Clin Transl Radiat Oncol. 2021 Apr 7;28:133-140. doi: 10.1016/j.ctro.2021.03.010. eCollection 2021 May.
6
Dosimetric comparison of coplanar and noncoplanar beam arrangements for radiotherapy of patients with lung cancer: A meta-analysis.非共面和共面射束治疗肺癌患者的剂量学比较：一项荟萃分析。
J Appl Clin Med Phys. 2021 Apr;22(4):34-43. doi: 10.1002/acm2.13197. Epub 2021 Feb 26.
7
Prognostic factors and clinical outcomes after stereotactic radiotherapy for primary lung tumors.原发性肺肿瘤立体定向放射治疗后的预后因素及临床结局
Rep Pract Oncol Radiother. 2020 Nov-Dec;25(6):943-950. doi: 10.1016/j.rpor.2020.09.015. Epub 2020 Oct 3.
8
First-line treatment selection with organoids of an m + m stage IA1 patient with early metastatic recurrence after radical surgery and follow-up.对一名根治性手术后出现早期转移复发的m + m期IA1患者，使用类器官进行一线治疗选择及随访。
J Thorac Dis. 2020 Jul;12(7):3764-3773. doi: 10.21037/jtd-20-1882.
本文引用的文献
1
Use of PET and Other Functional Imaging to Guide Target Delineation in Radiation Oncology.使用 PET 和其他功能成像来指导放射肿瘤学中的靶区勾画。
Semin Radiat Oncol. 2018 Jun;28(3):171-177. doi: 10.1016/j.semradonc.2018.02.001.
2
Long-term Results of Stereotactic Body Radiation Therapy in Medically Inoperable Stage I Non-Small Cell Lung Cancer.无法手术的 I 期非小细胞肺癌立体定向体部放疗的长期结果。
JAMA Oncol. 2018 Sep 1;4(9):1287-1288. doi: 10.1001/jamaoncol.2018.1258.
3
Photons, protons or carbon ions for stage I non-small cell lung cancer - Results of the multicentric ROCOCO in silico study.光子、质子还是碳离子治疗 I 期非小细胞肺癌 - 多中心 ROCOCO 模拟研究结果。
Radiother Oncol. 2018 Jul;128(1):139-146. doi: 10.1016/j.radonc.2018.02.024. Epub 2018 Mar 12.
4
Cancer statistics, 2018.癌症统计数据，2018 年。
CA Cancer J Clin. 2018 Jan;68(1):7-30. doi: 10.3322/caac.21442. Epub 2018 Jan 4.
5
Optimal imaging surveillance after stereotactic ablative radiation therapy for early-stage non-small cell lung cancer: Findings of an International Delphi Consensus Study.立体定向消融放疗后早期非小细胞肺癌的最佳影像学监测：一项国际德尔菲共识研究的结果。
Pract Radiat Oncol. 2018 Mar-Apr;8(2):e71-e78. doi: 10.1016/j.prro.2017.10.008. Epub 2017 Dec 30.
6
Improved Survival of Stage I Non-Small Cell Lung Cancer: A VA Central Cancer Registry Analysis.Ⅰ期非小细胞肺癌生存率的提高：VA 中央癌症登记分析。
J Thorac Oncol. 2017 Dec;12(12):1814-1823. doi: 10.1016/j.jtho.2017.09.1952. Epub 2017 Sep 23.
7
Outcomes of invasive mediastinal nodal staging versus positron emission tomography staging alone for early-stage non-small cell lung cancer treated with stereotactic body radiation therapy.立体定向体部放疗治疗早期非小细胞肺癌时，侵袭性纵隔淋巴结分期与正电子发射断层扫描（PET）分期单独应用的结果比较。
Lung Cancer. 2018 Mar;117:53-59. doi: 10.1016/j.lungcan.2017.07.005. Epub 2017 Jul 14.
8
Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive Summary of an ASTRO Evidence-Based Guideline.立体定向体部放射治疗早期非小细胞肺癌：ASTRO 循证指南的执行摘要。
Pract Radiat Oncol. 2017 Sep-Oct;7(5):295-301. doi: 10.1016/j.prro.2017.04.014. Epub 2017 Jun 5.
9
7-year follow-up after stereotactic ablative radiotherapy for patients with stage I non-small cell lung cancer: Results of a phase 2 clinical trial.I期非小细胞肺癌患者立体定向消融放疗后的7年随访：一项2期临床试验的结果
Cancer. 2017 Aug 15;123(16):3031-3039. doi: 10.1002/cncr.30693. Epub 2017 Mar 27.
10
Influence of Fractionation Scheme and Tumor Location on Toxicities After Stereotactic Body Radiation Therapy for Large (≥5 cm) Non-Small Cell Lung Cancer: A Multi-institutional Analysis.分割方案和肿瘤位置对大（≥5厘米）非小细胞肺癌立体定向体部放射治疗后毒性的影响：一项多机构分析
Int J Radiat Oncol Biol Phys. 2017 Mar 15;97(4):778-785. doi: 10.1016/j.ijrobp.2016.11.049. Epub 2016 Dec 2.
Zotero 插件