Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Department of Radiation Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Beijing, China.
Thorac Cancer. 2020 Mar;11(3):754-761. doi: 10.1111/1759-7714.13335. Epub 2020 Feb 3.
There is no consensus on the definition or recommended radiotherapy treatment of ultracentral non-small cell lung cancer (NSCLC). Here, we report our institution's experience in treating ultracentral lung cancer patients with stereotactic ablative radiotherapy (SABR) of 60 Gy in eight fractions.
We retrospectively reviewed the outcomes of 21 ultracentral NSCLC patients treated with 60 Gy SABR in eight fractions. We defined ultracentral lung cancer as the planning target volume (PTV) directly abutting or overlapping central structures, including the proximal bronchial tree, heart, and great vessels but not the esophagus. The Kaplan-Meier method was used to estimate overall survival (OS), progression-free survival (PFS) and local control (LC). Toxicity was scored per the CTCAE v4.03.
The median follow-up time was 15 months, and the median OS was 15 months. The one- and two-year OS rates were 87.5% and 76.6%, respectively. The one- and two-year PFS rates were 71.1% and 64.0%, respectively. The one- and two-year LC rates were 92.9% and 92.9%, respectively. The rate of grade 2 treatment-related toxicities was 19.1%. There was no grade ≥ 3 treatment-related toxicity.
SABR of 60 Gy in eight fractions is feasible for ultracentral NSCLC.
对于超中心非小细胞肺癌（NSCLC）的定义或推荐放疗治疗方法，目前尚无共识。在此，我们报告了我们机构使用 60Gy 分 8 次立体定向消融放疗（SABR）治疗超中心肺癌患者的经验。
我们回顾性分析了 21 例接受 60Gy 分 8 次 SABR 治疗的超中心 NSCLC 患者的结果。我们将超中心肺癌定义为计划靶区（PTV）直接毗邻或重叠中央结构，包括近端支气管树、心脏和大血管，但不包括食管。采用 Kaplan-Meier 法估计总生存期（OS）、无进展生存期（PFS）和局部控制率（LC）。毒性按 CTCAE v4.03 进行评分。
中位随访时间为 15 个月，中位 OS 为 15 个月。1 年和 2 年的 OS 率分别为 87.5%和 76.6%。1 年和 2 年的 PFS 率分别为 71.1%和 64.0%。1 年和 2 年的 LC 率分别为 92.9%和 92.9%。2 级治疗相关毒性发生率为 19.1%。无≥3 级治疗相关毒性。
60Gy 分 8 次 SABR 治疗超中心 NSCLC 是可行的。
