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立体定向体部放疗治疗肾癌:单中心 10 年经验。

Stereotactic body radiotherapy for kidney cancer: a 10-year experience from a single institute.

机构信息

Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.

Department of Urology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.

出版信息

J Radiat Res. 2021 May 12;62(3):533-539. doi: 10.1093/jrr/rrab031.

Abstract

The purpose of this retrospective study was to investigate survival outcomes and irradiated tumor control (local control [LC]) and locoregional control (LRC) after stereotactic body radiotherapy (SBRT) for T1 or recurrent T1 (rT1) kidney cancer. Twenty-nine nonconsecutive patients with 30 tumors were included. SBRT doses of 70 Gy, 60 Gy or 50 Gy in 10 fractions were prescribed with a linear accelerator using daily image guidance. The Kaplan-Meier method was used to estimate time-to-event outcomes, and the log-rank test was used to compare survival curves between groups divided by each possible factor. The median follow-up periods for all patients and survivors were 57 months and 69.6 months, respectively. The five-year LC rate, LRC rate, progression-free survival (PFS) rate, disease-specific survival (DSS) rate and overall survival (OS) rate were 94%, 88%, 50%, 96% and 68%, respectively. No significant factor was related to OS and PFS. Three of 24 non-hemodialysis (HD) patients had new-onset-HD because of the progression of underlying kidney disease. Grade 3 or higher toxicities from SBRT did not occur. In conclusion, SBRT for kidney cancer provided a high rate of LC, LRC and DSS with minimal toxicities, but patient selection and indication for SBRT should be done carefully considering the relatively low OS rate.

摘要

这项回顾性研究的目的是调查立体定向体部放疗(SBRT)治疗 T1 或复发性 T1(rT1)肾癌的生存结果和受照射肿瘤控制(局部控制[LC])和局部区域控制(LRC)。共纳入 29 例非连续患者的 30 个肿瘤。使用直线加速器每日图像引导,处方 SBRT 剂量为 70Gy、60Gy 或 50Gy,共 10 个分次。采用 Kaplan-Meier 法估计时间事件结果,对数秩检验比较按每个可能因素分组的生存曲线。所有患者和幸存者的中位随访期分别为 57 个月和 69.6 个月。五年 LC 率、LRC 率、无进展生存期(PFS)率、疾病特异性生存率(DSS)率和总生存率(OS)率分别为 94%、88%、50%、96%和 68%。无任何因素与 OS 和 PFS 相关。24 例非血液透析(HD)患者中有 3 例因基础肾脏病进展而新发 HD。SBRT 无 3 级或 3 级以上毒性。总之,SBRT 治疗肾癌具有较高的 LC、LRC 和 DSS 率,且毒性最小,但考虑到 OS 率相对较低,应谨慎选择患者并确定 SBRT 的适应证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9d5/8127673/766ee96545b5/rrab031f1.jpg

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