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接受立体定向体部放疗的肺部寡转移患者的治疗结果。

Outcome of lung oligometastatic patients treated with stereotactic body irradiation.

作者信息

Virbel Guillaume, Cox David G, Olland Anne, Falcoz Pierre-Emmanuel, Le Fevre Clara, Schott Roland, Antoni Delphine, Noel Georges

机构信息

Department of Radiation Oncology, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.

IRFAC - Statistic Department, INSERM U1113, Strasbourg, France.

出版信息

Front Oncol. 2022 Jul 18;12:945189. doi: 10.3389/fonc.2022.945189. eCollection 2022.

Abstract

PURPOSE

The oligometastatic stage is an intermediate stage of cancer between the localized stage and polymetastatic stage. The prognosis of patients in this stage also appears to be intermediate. Lung stereotactic body radiotherapy is a possible tool for treating oligometastatic lung sites. The objective of our study was to evaluate the clinical outcomes in terms of local control, progression-free survival, overall survival, and toxicity of SBRT in oligometastatic patients with lung metastases from any solid primary tumor.

MATERIALS AND METHODS

Clinical records of consecutive lung oligometastatic patients treated between January 2010 and December 2020 for lung SBRT at 60 Gy in 3- or 8-fraction schedules and a controlled primary tumor were retrospectively analyzed.

RESULTS

After a median follow-up of 20.3 months, local failure occurred for 14 lesions, 57 patients experienced lung progression, and 64 patients experienced disease progression. Overall survival rates at 1 and 2 years were 85.6 and 69.7%, respectively. Fifty-two patients experienced radiation pneumonitis, but only 2 patients were symptomatic and presented grade 2 late pneumonitis. No grade 3-4 toxicity was observed. ECOG 0 was the only prognostic factor for overall survival (HR = 3.5; 95% CI 3.2-3.8; p < 0.01).

CONCLUSION

SBRT with a 60-Gy schedule in 8 fractions is an effective and well-tolerated treatment for patients with lung oligometastases from any solid primary tumor.

摘要

目的

寡转移阶段是癌症在局部阶段和多转移阶段之间的中间阶段。该阶段患者的预后似乎也处于中间状态。肺部立体定向体部放疗是治疗寡转移肺部病灶的一种可能手段。我们研究的目的是评估立体定向体部放疗(SBRT)对来自任何实体原发肿瘤的肺转移寡转移患者在局部控制、无进展生存期、总生存期和毒性方面的临床结果。

材料与方法

回顾性分析2010年1月至2020年12月期间接受肺部SBRT治疗(60 Gy,分3次或8次)且原发肿瘤得到控制的连续肺寡转移患者的临床记录。

结果

中位随访20.3个月后,14个病灶出现局部失败,57例患者出现肺部进展,64例患者出现疾病进展。1年和2年的总生存率分别为85.6%和69.7%。52例患者发生放射性肺炎,但只有2例有症状,表现为2级晚期肺炎。未观察到3 - 4级毒性反应。ECOG 0是总生存期的唯一预后因素(HR = 3.5;95% CI 3.2 - 3.8;p < 0.01)。

结论

8分次60 Gy方案的SBRT对来自任何实体原发肿瘤的肺寡转移患者是一种有效且耐受性良好的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2292/9393880/68cb5b90a00c/fonc-12-945189-g001.jpg

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