一项针对因肺癌导致气道阻塞而接受姑息性放疗患者的回顾性研究。
A Retrospective Study of Patients Undergoing Palliative Radiotherapy for Airway Obstruction due to Lung Cancer.
作者信息
Utsumi Nobuko, Takahashi Takeo, Yamano Takafumi, Machida Fumiharu, Kanamori Shinsuke, Saito Mio, Soda Rikana, Ueno Shuichi, Hayakawa Toyokazu, Hatanaka Shogo, Shimbo Munefumi
机构信息
Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Department of Radiation Therapy, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan.
出版信息
Cancer Diagn Progn. 2023 Jan 3;3(1):61-66. doi: 10.21873/cdp.10180. eCollection 2023 Jan-Feb.
BACKGROUND/AIM: In advanced stage lung cancer, bulky tumors can cause serious symptoms such as malignant airway obstruction (MAO). Prompt response to airway obstruction might be essential to improve quality of life and prolong life expectancy. Palliative external beam radiotherapy (EBRT) is a less invasive and highly safe treatment method that can alleviate symptoms and at the same time treat lung cancer. However, there are few reports on the results of palliative radiotherapy performed for improving airway obstruction and obstructive pneumonia. Therefore, this study retrospectively examined the effectiveness of palliative radiotherapy.
PATIENTS AND METHODS
We reviewed 38 lung cancer patients with MAO who underwent EBRT. Patients were treated with a median dose of 37.5 Gy (range=30-40 Gy) in 10-20 fractions. Whether a patient was a responder or non-responder was assessed by whether the bronchus that was obstructed before EBRT reopened or improvement of obstructive pneumonia was observed on follow-up chest X-ray or computed tomography after EBRT.
RESULTS
The median survival time was 135 days (range=31-469 days) for the responders to EBRT and 45 days (range=23-355 days) for non-responders; this difference was statistically significant (p=0.03). One-year overall survival rate was 18.5% and 0% for the responders to EBRT and non-responders, respectively.
CONCLUSION
Palliative EBRT might be an important option for non-curative lung cancer patients with MAO.
背景/目的：在晚期肺癌中，巨大肿瘤可导致严重症状，如恶性气道阻塞（MAO）。对气道阻塞的迅速反应可能对改善生活质量和延长预期寿命至关重要。姑息性外照射放疗（EBRT）是一种侵入性较小且安全性高的治疗方法，可缓解症状并同时治疗肺癌。然而，关于为改善气道阻塞和阻塞性肺炎而进行的姑息性放疗结果的报道很少。因此，本研究回顾性地研究了姑息性放疗的有效性。
患者与方法
我们回顾了38例接受EBRT的MAO肺癌患者。患者接受的中位剂量为37.5 Gy（范围=30 - 40 Gy），分10 - 20次照射。根据EBRT前阻塞的支气管是否重新开放或在EBRT后的随访胸部X线或计算机断层扫描中观察到阻塞性肺炎是否改善，来评估患者是反应者还是无反应者。
结果
EBRT反应者的中位生存时间为135天（范围=31 - 469天），无反应者为45天（范围=23 - 355天）；这种差异具有统计学意义（p = 0.03）。EBRT反应者和无反应者的1年总生存率分别为18.5%和0%。
结论
姑息性EBRT可能是患有MAO的非治愈性肺癌患者的重要选择。
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