Kanzaki Ryu, Suzuki Osamu, Kanou Takashi, Ose Naoko, Funaki Soichiro, Shintani Yasushi, Minami Masato, Tamari Keisuke, Otani Keisuke, Seo Yuji, Isohashi Fumiaki, Ogawa Kazuhiko, Okumura Meinoshin
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Japan.
J Cardiothorac Surg. 2020 Feb 27;15(1):43. doi: 10.1186/s13019-020-1079-4.
Stereotactic body radiation therapy (SBRT) has recently been widely performed for relatively small-volume tumors. We analyzed the short-term outcomes of pulmonary metastasectomy (PM) or SBRT for pulmonary metastases.
This study was a retrospective analysis of 82 patients with pulmonary metastasis from epithelial tumors who underwent PM or SBRT between 2013 and 2016.
Fifty-nine patients underwent PM, 21 patients underwent SBRT, and 2 patients underwent combined PM and SBRT. The mean age of the PM group was significantly lower than that of the SBRT group (60.6 vs 67.4 years, p = 0.03). The most frequent types of primary tumor in the PM and SBRT groups were colorectal cancer (n = 27, 46%) and head and neck squamous cell carcinoma (n = 8, 38%), respectively. The rate of treatment-associated complications did not differ between the two groups to a statistically significant extent (20% vs 24%, p = 0.76). The 3-year local control rates of the two groups were similar (PM group, 88%; SBRT group, 92%; p = 0.48). The 3-year progression-free survival (PFS) rate of the PM group were better than that of SBRT groups (42% vs 11%, p = 0.01). The 3-year overall survival (OS) rates of the PM and SBRT groups were 77 and 52% respectively; although the rate of the PM group was higher, the difference was not statistically significant (p = 0.10).
SBRT provides a favorable 3-year local control rate. The 3-year OS rate of the SBRT group tended to be lower than that of the PM group, despite the difference was not statistically significant. PM and SBRT play complementary roles in patients with pulmonary metastases.
立体定向体部放射治疗（SBRT）近来已广泛应用于相对小体积肿瘤的治疗。我们分析了肺转移瘤肺转移灶切除术（PM）或SBRT的短期疗效。
本研究是一项对2013年至2016年间接受PM或SBRT治疗的82例上皮性肿瘤肺转移患者的回顾性分析。
59例患者接受了PM，21例患者接受了SBRT，2例患者接受了PM联合SBRT。PM组的平均年龄显著低于SBRT组（60.6岁对67.4岁，p = 0.03）。PM组和SBRT组最常见的原发肿瘤类型分别为结直肠癌（n = 27，46%）和头颈部鳞状细胞癌（n = 8，38%）。两组治疗相关并发症发生率在统计学上无显著差异（20%对24%，p = 0.76）。两组的3年局部控制率相似（PM组，88%；SBRT组，92%；p = 0.48）。PM组的3年无进展生存率（PFS）优于SBRT组（42%对11%，p = 0.01）。PM组和SBRT组的3年总生存率（OS）分别为77%和52%；尽管PM组的生存率较高，但差异无统计学意义（p = 0.10）。
SBRT提供了良好的3年局部控制率。SBRT组的3年OS率虽有低于PM组的趋势，但差异无统计学意义。PM和SBRT在肺转移患者中发挥着互补作用。
