Aye Shoon Mya, Kyi Lin Lin, Hlaing Moe, Myint Aye Aye, Win Khin Cho
Radiotherapy Department, Yangon General Hospital, Yangon, Myanmar.
Rep Pract Oncol Radiother. 2021 Sep 30;26(5):747-755. doi: 10.5603/RPOR.a2021.0095. eCollection 2021.
This study aimed to evaluate short term clinical outcomes of accelerated hypofractionated radiotherapy (AHR T) regarding locoregional response (LRR), symptoms relief and acute toxicities in non-small cell lung cancer (NSCLC) patients. The radical treatment for inoperable NSCLC is intolerable for some patients. An alternative RT regime should be considered for them.
Inoperable NSCLC patients who could not tolerate radical treatment were treated with AHRT (45 Gy in 15 fractions over three weeks) by using the 3-dimensional conformal (RT) technique. The LRR was assessed by chest computed tomography (CT) performed before and 6 weeks after RT. Relief of symptoms such as cough, dyspnoea and chest pain was evaluated during RT and 6 and 12 weeks after RT, compared with the status before RT. Treatment-related acute toxicities such as dysphagia and radiation dermatitis were observed during and 6 and 12 weeks after RT.
Total 65 patients (seven patients of stage II and fifty-eight patients of stage III) were included. Partial response was seen in 70.8% of patients, and stable disease was seen in 29.2% while there was neither complete response nor progressive disease after RT. Statistically significant associations were found between tumour response vs. pre-treatment tumour size and tumour response vs. performance status of the patients. Satisfactory symptom relief was found after RT, but severe acute dysphagia and radiation dermatitis (more than grade 3) were not observed.
Satisfactory LRR, symptom relief and acute toxicities were achieved by this regime. Long term studies are recommended to evaluate late toxicities and survival outcome further.
TCTR20200110001.
本研究旨在评估加速超分割放疗（AHR T）在局部区域反应（LRR）、症状缓解及急性毒性方面对非小细胞肺癌（NSCLC）患者的短期临床疗效。对于一些无法耐受手术的NSCLC患者，根治性治疗难以承受，因此应考虑为他们采用替代的放疗方案。
无法耐受根治性治疗的不可手术NSCLC患者采用三维适形放疗技术接受AHR T（3周内分15次给予45 Gy）。放疗前及放疗后6周通过胸部计算机断层扫描（CT）评估LRR。与放疗前状态相比，在放疗期间以及放疗后6周和12周评估咳嗽、呼吸困难和胸痛等症状的缓解情况。在放疗期间以及放疗后6周和12周观察吞咽困难和放射性皮炎等与治疗相关的急性毒性反应。
共纳入65例患者（II期7例，III期58例）。70.8%的患者出现部分缓解，29.2%的患者病情稳定，放疗后既无完全缓解也无疾病进展。在肿瘤反应与治疗前肿瘤大小以及肿瘤反应与患者体能状态之间发现了具有统计学意义的关联。放疗后症状缓解情况良好，但未观察到严重的急性吞咽困难和放射性皮炎（超过3级）。
该方案在LRR、症状缓解及急性毒性方面取得了令人满意的效果。建议进行长期研究以进一步评估晚期毒性和生存结局。
TCTR20200110001。
