Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Departments of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Cancer Res Treat. 2023 Oct;55(4):1181-1189. doi: 10.4143/crt.2022.1656. Epub 2023 Mar 21.
The detection rate of early-stage lung cancer with ground-glass opacity (GGO) has increased, and stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable patients. However, reports on treatment results are limited. Therefore, we performed a retrospective study to investigate the clinical outcome after SBRT in patients with early-stage lung cancer with GGO-predominant tumor lesions at a single institution.
This study included 89 patients with 99 lesions who were treated with SBRT for lung cancer with GGO-predominant lesions that had a consolidation-to-tumor ratio of ≤0.5 at Asan Medical Center between July 2016 and July 2021. A median total dose of 56.0 Gy (range, 48.0-60.0) was delivered using 10.0-15.0 Gy per fraction.
The overall follow-up period for the study was median 33.0 months (range, 9.9 to 65.9 months). There was 100% local control with no recurrences in any of the 99 treated lesions. Three patients had regional recurrences outside of the radiation field, and three had distant metastasis. The 1-year, 3-year, and 5-year overall survival rates were 100.0%, 91.6%, and 82.8%, respectively. Univariate analysis revealed that advanced age and a low level of diffusing capacity of the lungs for carbon monoxide were significantly associated with overall survival. There were no patients with grade ≥3 toxicity.
SBRT is a safe and effective treatment for patients with GGO-predominant lung cancer lesions and is likely to be considered as an alternative to surgery.
磨玻璃密度(GGO)肺癌的检出率有所增加,对于不能手术的患者,立体定向体部放疗(SBRT)已被建议作为一种替代手术的方法。然而,关于治疗结果的报道有限。因此,我们在单一机构中进行了一项回顾性研究,以调查 SBRT 治疗以 GGO 为主的早期肺癌患者的临床结果。
本研究纳入了 2016 年 7 月至 2021 年 7 月在 Asan 医疗中心因 GGO 为主的肺癌病变且肿瘤实性成分与肿瘤比值≤0.5 接受 SBRT 治疗的 89 例患者,共 99 个病灶。中位总剂量为 56.0 Gy(范围,48.0-60.0 Gy),采用 10.0-15.0 Gy/次分割。
本研究的总体随访时间为中位数 33.0 个月(范围,9.9-65.9 个月)。99 个治疗病灶均达到了 100%的局部控制,无一例复发。3 例患者发生放射野外的区域性复发,3 例发生远处转移。1 年、3 年和 5 年的总生存率分别为 100.0%、91.6%和 82.8%。单因素分析显示,高龄和一氧化碳弥散量低与总生存率显著相关。没有患者出现≥3 级毒性。
SBRT 是治疗以 GGO 为主的肺癌病变的一种安全有效的方法,可能被视为手术的替代方法。