Alongi F, Nicosia L, Figlia V, De Sanctis V, Mazzola R, Giaj-Levra N, Reverberi C, Valeriani M, Osti M F
Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy.
University of Brescia, Brescia, Italy.
Clin Transl Oncol. 2021 Oct;23(10):2133-2140. doi: 10.1007/s12094-021-02619-4. Epub 2021 Apr 10.
Stereotactic body radiotherapy (SBRT) is a consolidate treatment for inoperable early-stage lung tumors, usually delivered in single or multi-fraction regimens. We aimed to compare these two approaches in terms of local effectiveness, safety and survival.
Patients affected by medically inoperable early-stage lung tumor were treated at two Institutions with two different schedules: 70 Gy in ten fractions (TF) (BED10: 119 Gy) or 30 Gy in single fraction (SF) (BED10: 120 Gy).
73 patients were treated with SBRT delivered with two biological equivalent schedules: SF (44) and TF (29). The median follow-up was 34 months (range 3-81 months). Three-year Overall survival (OS) was 57.9%, 3-year cancer-specific survival (CSS) was 77.2%, with no difference between treatment groups. Three-year progression-free survival (LPFS) was 88.9% and did not differs between SF and TF. Overall, four cases (5.4%) of acute grade ≥ 3 pneumonitis occurred. No differences in acute and late toxicity between the two groups were detected.
SF and TF seems to be equally safe and effective in the treatment of primary inoperable lung tumors especially for smaller lesion. The SF may be preferentially offered to reduce patient access to hospital with no negative impact on tumor control and survival.
立体定向体部放疗（SBRT）是一种针对无法手术的早期肺部肿瘤的巩固治疗方法，通常采用单次或多次分割方案。我们旨在比较这两种方法在局部疗效、安全性和生存率方面的差异。
在两家机构对患有医学上无法手术的早期肺部肿瘤的患者采用两种不同方案进行治疗：10次分割给予70 Gy（TF）（BED10：119 Gy）或单次分割给予30 Gy（SF）（BED10：120 Gy）。
73例患者接受了采用两种生物等效方案的SBRT治疗：SF（44例）和TF（29例）。中位随访时间为34个月（范围3 - 81个月）。三年总生存率（OS）为57.9%，三年癌症特异性生存率（CSS）为77.2%，治疗组之间无差异。三年无进展生存率（LPFS）为88.9%，SF和TF之间无差异。总体而言，发生了4例（5.4%）急性≥3级肺炎。两组之间在急性和晚期毒性方面未检测到差异。
SF和TF在治疗原发性无法手术的肺部肿瘤，尤其是较小病变方面似乎同样安全有效。SF可能更适合优先采用，以减少患者的住院次数，且对肿瘤控制和生存率无负面影响。
