巴西真实世界中与立体定向体部放射疗法相关的健康结果的证据。

Real-World Evidence of Health Outcomes Related to Lung Stereotactic Body Radiation Therapy in Brazil.

机构信息

Instituto COI de Pesquisa e Ensino, Rio de Janeiro, Brazil.

Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil.

出版信息

JCO Glob Oncol. 2022 Nov;8:e2200061. doi: 10.1200/GO.22.00061.

DOI:10.1200/GO.22.00061

PMID:36351211

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10166467/

Abstract

PURPOSE

Stereotactic body radiation therapy (SBRT) is an effective option for patients with both early-stage and oligometastatic non-small-cell lung cancer (NSCLC). However, data from Latin America are limited. Therefore, the aim of this study was to investigate the real-world outcomes of applying SBRT for lung lesions in a Brazilian institution.

METHODS

This study investigated a consecutive cohort of patients treated with SBRT for lung lesions (primary and metastasis). The study primary outcome was local control rates per lesion. Secondary outcomes included progression-free survival (PFS), overall survival (OS), and toxicity.

RESULTS

Between 2015 and 2019, a total of 216 patients received SBRT and were included in the study. The median follow-up was 24.5 months (5-70), primary NSCLC corresponded to 70% (n = 151) and nonprimary lung lesions to 30% (n = 65), respectively. Stage I NSCLC represented 56% (85 of 151) of the NSCLC cohort. The average number of fractions and total dose prescribed was 5 (3-10)/59 Gy (50-62 Gy). For stage I NSCLC (all lesions treated with a biologically effective dose [10] > 100 Gy), 2-year local control, OS, and PFS were 93.4%, 81.6%, and 80.7%, respectively. For stage IV lesions, if biologically effective dose (10) > 100 Gy or < 100 Gy, 2-year local control was 95.8/86.4% ( = .03), 2-year-OS was 81.6/60.5% ( = .006), and 2-year PFS was 38.9/17.9% ( = .10). Late toxicity was observed in 16.2% (n = 35) of the total cases.

CONCLUSION

Our results indicate that SBRT is effective (high local control and acceptable toxicity) for treating malignant lung lesions in a real-world scenario in Latin America.

摘要

目的

立体定向体部放射治疗（SBRT）是治疗早期和寡转移非小细胞肺癌（NSCLC）患者的有效选择。然而，来自拉丁美洲的数据有限。因此，本研究旨在调查巴西机构应用 SBRT 治疗肺部病变的真实世界结果。

方法

本研究调查了一组连续接受 SBRT 治疗肺部病变（原发性和转移性）的患者。研究的主要结局是每个病变的局部控制率。次要结局包括无进展生存期（PFS）、总生存期（OS）和毒性。

结果

2015 年至 2019 年间，共有 216 例患者接受 SBRT 治疗并纳入研究。中位随访时间为 24.5 个月（5-70），原发性 NSCLC 占 70%（n=151），非原发性肺部病变占 30%（n=65）。Ⅰ期 NSCLC 占 NSCLC 队列的 56%（85/151）。所规定的平均分割次数和总剂量为 5（3-10）/59 Gy（50-62 Gy）。对于Ⅰ期 NSCLC（所有用生物有效剂量[10] > 100 Gy 治疗的病变），2 年局部控制率、OS 和 PFS 分别为 93.4%、81.6%和 80.7%。对于Ⅳ期病变，如果生物有效剂量（10）> 100 Gy 或< 100 Gy，2 年局部控制率为 95.8/86.4%（=.03），2 年 OS 为 81.6/60.5%（=.006），2 年 PFS 为 38.9/17.9%（=.10）。总共有 16.2%（n=35）的病例出现迟发性毒性。