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日本质子束治疗胃食管结合部癌肝寡转移瘤的全国队列研究数据。

The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in esophagogastric cancer patients.

机构信息

Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima 960-1295, Japan.

Department of Radiology, Southern Tohoku Proton Therapy Center, 7-172 Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.

出版信息

J Radiat Res. 2023 Nov 21;64(6):926-932. doi: 10.1093/jrr/rrad066.

Abstract

A nationwide multicenter cohort study on particle therapy was launched by the Japanese Society for Radiation Oncology in Japan in May 2016. We analyzed the outcome of proton beam therapy (PBT) for liver oligometastasis of esophagogastric cancers. Cases in which PBT was performed at all PBT facilities in Japan between May 2016 and February 2019 were enrolled. The patients were selected based on the following criteria: controlled primary cancer, liver recurrence without extrahepatic tumors and no more than three liver lesions. Twenty-two males and two females with a median age of 69 (range, 52-80) years and 35 lesions were included. This study included 6 patients with esophageal and 18 patients with gastric cancer. The median lesion size, fraction size and biological effective dose (BED)10 were 32 (7-104) mm, 3.8 gray (relative biological effect)/fractions (Gy (RBE)/fr) (2-8 Gy (RBE)/fr) and 96.9 (88.8-115.2) Gy, respectively. The median follow-up period was 18 (4-47) months. The 1-, 2- and 3-year overall survival (OS) rates were 75, 51.8 and 45.3%, respectively, and the median OS was 25.3 months. The 1-, 2- and 3-year cumulative local recurrence (LR) rates were 3, 6 and 6%, respectively. Patients' age (P < 0.01), performance status (P = 0.017) and tumor size (P = 0.024) were significant OS-related factors. No Grade 3 or higher adverse events (AEs) were observed. Owing to the low incidence of AEs and the low LR cumulative incidence, PBT is a feasible option for liver oligometastasis of esophagogastric cancers.

摘要

一项由日本放射肿瘤学会于 2016 年 5 月在日本发起的全国多中心质子束治疗队列研究,分析了质子束治疗(PBT)治疗胃食管癌症肝寡转移的结果。本研究纳入了 2016 年 5 月至 2019 年 2 月期间在所有质子束治疗中心接受 PBT 的病例。纳入标准为:原发肿瘤得到控制、肝转移灶无肝外转移且不超过 3 个病灶。共纳入 22 例男性和 2 例女性,中位年龄 69 岁(范围 52-80 岁),35 个病灶。本研究包括 6 例食管癌和 18 例胃癌患者。中位病灶大小、分割剂量和生物有效剂量(BED)10 分别为 32(7-104)mm、3.8 戈瑞(相对生物效应)/分次(Gy(RBE)/分次)(2-8 Gy(RBE)/分次)和 96.9(88.8-115.2)Gy。中位随访时间为 18(4-47)个月。1、2 和 3 年总生存率(OS)分别为 75%、51.8%和 45.3%,中位 OS 为 25.3 个月。1、2 和 3 年累积局部复发(LR)率分别为 3%、6%和 6%。患者年龄(P<0.01)、体力状况(P=0.017)和肿瘤大小(P=0.024)是影响 OS 的显著因素。未观察到 3 级或更高级别的不良事件(AE)。由于 AE 发生率低且 LR 累积发生率低,PBT 是胃食管癌症肝寡转移的一种可行选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c59/10665303/7549204b9d7f/rrad066f1.jpg

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