Bartl Austin J, Mahoney Mary, Hennon Mark W, Yendamuri Sai, Videtic Gregory M M, Stephans Kevin L, Siva Shankar, Farrugia Mark K, Ma Sung Jun, Singh Anurag K
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA.
College of Medicine, State University of New York Upstate Medical University, Syracuse, NY 13210, USA.
Cancers (Basel). 2022 Feb 3;14(3):790. doi: 10.3390/cancers14030790.
Adoption of single-fraction lung stereotactic body radiation therapy (SBRT) for patients with medically inoperable early stage non-small-cell lung cancer (NSCLC) or oligometastatic lung disease, even during the coronavirus disease 2019 (COVID-19) pandemic, was limited despite encouraging phase II trial results. Barriers to using single-fraction SBRT may include lack of familiarity with the regimen and lack of clarity about the expected toxicity. To address these concerns, we performed a systematic review of prospective literature on single-fraction SBRT for definitive treatment of early stage and oligometastatic lung cancer. A PubMed search of prospective studies in English on single-fraction lung SBRT was conducted. A systematic review was performed of the studies that reported clinical outcomes of single-fraction SBRT in the treatment of early stage non-small-cell lung cancer and lung oligometastases. The current prospective literature including nine trials supports the use of single-fraction SBRT in the definitive treatment of early stage peripheral NSCLC and lung oligometastases. Most studies cite local control rates of >90%, mild toxicity profiles, and favorable survival outcomes. Most toxicities reported were grade 1-2, with grade ≥3 toxicity in 0-17% of patients. Prospective trial results suggest potential consideration of utilizing single-fraction SBRT beyond the COVID-19 pandemic.
对于患有医学上无法手术的早期非小细胞肺癌（NSCLC）或寡转移肺疾病的患者，即使在2019年冠状病毒病（COVID-19）大流行期间，采用单次分割立体定向体部放疗（SBRT）的情况仍然有限，尽管II期试验结果令人鼓舞。使用单次分割SBRT的障碍可能包括对该方案不熟悉以及对预期毒性不明确。为了解决这些问题，我们对关于单次分割SBRT用于早期和寡转移肺癌确定性治疗的前瞻性文献进行了系统综述。在PubMed上搜索了关于单次分割肺部SBRT的英文前瞻性研究。对报告单次分割SBRT治疗早期非小细胞肺癌和肺寡转移临床结果的研究进行了系统综述。目前包括9项试验的前瞻性文献支持单次分割SBRT用于早期周围型NSCLC和肺寡转移的确定性治疗。大多数研究引用的局部控制率>90%，毒性反应较轻，生存结果良好。报告的大多数毒性为1-2级，≥3级毒性的患者占0-17%。前瞻性试验结果表明，在COVID-19大流行之后可能需要考虑使用单次分割SBRT。
