Le Reun E, Casutt A, Durham A, Bouchaab H, Romano E, Lovis A, Krueger T, Von Garnier C, Özsahin E M, Kinj R
Department of Radiation Oncology, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland; Institut national de la santé et de la recherche médicale (Inserm), U1296 Research Unit « Radiations: Defense, Health and Environment », centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
Division of Pulmonology, University Hospital Center of Lausanne (CHUV), rue du Bugnon 46, 1011 Lausanne, Switzerland; Lausanne University (UNIL), Lausanne, Switzerland.
Cancer Radiother. 2023 Feb;27(1):31-41. doi: 10.1016/j.canrad.2022.05.003. Epub 2022 Aug 11.
To compare three different radiotherapy devices able to perform pulmonary stereotactic radiotherapy: CyberKnife® (CK), Helical Tomotherapy® (HT), and volumetric modulated arc therapy (VMAT). This study aims to define the patients' outcome in terms of SBRT efficacy and toxicities depending of the device choice.
We retrospectively analyzed the clinical, radiological, and dosimetric data of patients treated with lung SBRT between 2016 and 2020 at Lausanne University Hospital, using the Chi test for proportions, the t-test for means comparisons, the Kaplan-Meier method for survival, and the Log-rank test and Cox-regression for intergroups comparisons.
We identified 111 patients treated by either CK (59.9%), VMAT (38.0%), or HT (2.1%). Compared to other techniques, CK treated comparable gross tumor volume (GTV; 2.1 vs. 1.4cm, P=0.84) with smaller planning treatment volume (PTV; 12.3 vs. 21.9cm, P=0.013) and lower V5 (13.5 vs. 19.9cm, P=0.002). Local control rates at 2years were not different whatever the irradiation device, respectively of 96.2% (range, 90.8-100) and 98.1% (range, 94.4-100), P=0.68. Toxicity incidence significantly increased with V5 value>17.2% (56.0 vs. 77.4%, P=0.021).
Compared to other SBRT techniques, CK treatments permitted to treat comparable GTV with reduced PTV and V5. Toxicity incidence was less frequent when reducing the V5. CK is particularly attractive in case of multiple courses of lung SBRT or lung reirradiation.
比较三种能够进行肺部立体定向放射治疗的不同放疗设备：射波刀（CyberKnife®，CK）、螺旋断层放射治疗系统（Helical Tomotherapy®，HT）和容积调强弧形治疗（volumetric modulated arc therapy，VMAT）。本研究旨在根据所选设备确定患者在立体定向体部放疗疗效和毒性方面的结果。
我们回顾性分析了2016年至2020年在洛桑大学医院接受肺部立体定向体部放疗患者的临床、放射学和剂量学数据，使用卡方检验进行比例比较，t检验进行均值比较，Kaplan-Meier法进行生存分析，对数秩检验和Cox回归进行组间比较。
我们确定了111例接受CK（59.9%）、VMAT（38.0%）或HT（2.1%）治疗的患者。与其他技术相比，CK治疗的大体肿瘤体积（gross tumor volume，GTV）相当（2.1 vs. 1.4cm，P = 0.84），计划治疗体积（planning treatment volume，PTV）较小（12.
