重复立体定向体部放射治疗肺部恶性肿瘤：通过避免肺部照射可降低毒性。
Repeated Stereotactic Body Radiotherapy for Lung Malignancies: Toxicity Can Be Reduced by Sparing Lung Irradiation.
机构信息
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
出版信息
Anticancer Res. 2022 May;42(5):2701-2709. doi: 10.21873/anticanres.15748.
BACKGROUND/AIM: Evidence on the use of repeated stereotactic body radiotherapy (SBRT) is limited. We investigated the efficacy of repeated SBRT and predictors of lung toxicity.
PATIENTS AND METHODS
We reviewed 20 patients (27 lesions) with primary or metastatic lung cancer who underwent repeated SBRT with CyberKnife We generated a composite plan for dosimetric analysis based on equivalent doses in 2.0-Gy fractions (α/β=3). Predictors of Grade 2+ radiation pneumonitis (RP) were examined.
RESULTS
The median follow-up duration was 18.0 months. The 1-year and 2-year local control were both 95.2%. Five patients (25%) developed Grade 2+ RP, including a Grade 5 RP. The Grade 2+ RP group showed higher composite mean lung dose (MLD) and lower lung volumes spared from 5-20 Gy (VS5-VS20).
CONCLUSION
Repeated SBRT with CyberKnife showed favorable local control, but a high rate of Grade 2+ RP. Accumulated MLD and VS5-VS20 may predict RP.
背景/目的：关于重复立体定向体放射治疗（SBRT）的应用证据有限。我们研究了重复 SBRT 的疗效和肺毒性的预测因素。
患者和方法
我们回顾了 20 名（27 个病灶）接受 CyberKnife 重复 SBRT 的原发性或转移性肺癌患者。我们根据等效剂量 2.0-Gy 分数（α/β=3）生成了剂量分析的综合计划。检查了 2+级放射性肺炎（RP）的预测因素。
结果
中位随访时间为 18.0 个月。1 年和 2 年局部控制率均为 95.2%。5 名患者（25%）发生 2+级 RP，包括 1 例 5 级 RP。2+级 RP 组的复合平均肺剂量（MLD）较高，5-20Gy spared lung volumes（VS5-VS20）较低。
结论
CyberKnife 重复 SBRT 显示出良好的局部控制效果，但 2+级 RP 发生率较高。累积 MLD 和 VS5-VS20 可能预测 RP。
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