Ciudad Real General University Hospital, C. Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain.
Toledo University Hospital, Toledo, Spain.
Clin Transl Oncol. 2024 May;26(5):1203-1208. doi: 10.1007/s12094-023-03345-9. Epub 2023 Nov 28.
Lung SBRT has a well-defined role in the treatment of patients with early stage non-small cell lung cancer who are not surgical candidates or refuse surgery. Biologically effective dose (BED) of greater than or equal to 100 Gy has been recommended. However, optimal fractionation remains unclear. Our objective was analyze patients treated with lung SBRT in our institution and evaluate outcomes according prescribed dose.
One hundred nine patients with early non-small cell lung cancer and treated with lung SBRT were retrospectively analyzed. Differences between dose received, local control, and survival were evaluated. For comparison of BEDs, the prescribed dose for SBRT was stratified according to two groups: high (BED > 120 Gy) and low (BED < 120 Gy).
A relationship between mortality and total dose (54.7 Gy ± 4.8) was observed. Significantly worse survival was observed for patients with higher total doses (p < 0.003). It was found that patients receiving BED > 120 had increased mortality compared to patients receiving BED < 120 (p = 0.021). It was observed mean dose/fraction 12.6 Gy/f was a protective factor and decreased the probability of death.
Our data suggest that mean total dose lower 54 and a calculated BED < 120 Gy is the optimal. Further prospective data are needed to confirm these results and determine the optimal dose fractionation scheme as a function of tumor size and location of volume.
立体定向体部放疗（SBRT）在治疗不适合手术或拒绝手术的早期非小细胞肺癌患者方面具有明确的作用。推荐生物有效剂量（BED）大于或等于 100Gy。然而，最佳分割方案仍不清楚。我们的目的是分析在我们机构接受肺部 SBRT 治疗的患者，并根据规定的剂量评估结果。
回顾性分析了 109 例早期非小细胞肺癌患者，接受了肺部 SBRT 治疗。评估了所接受的剂量、局部控制和生存之间的差异。为了比较 BED，将 SBRT 的规定剂量分为两组：高（BED>120Gy）和低（BED<120Gy）。
观察到死亡率与总剂量（54.7Gy±4.8）之间存在关系。总剂量较高的患者生存明显较差（p<0.003）。发现接受 BED>120 的患者死亡率高于接受 BED<120 的患者（p=0.021）。观察到平均剂量/分割 12.6Gy/分割是一个保护因素，可以降低死亡的概率。
我们的数据表明，平均总剂量低于 54Gy 和计算的 BED<120Gy 是最佳的。需要进一步的前瞻性数据来证实这些结果，并确定最佳的剂量分割方案，作为肿瘤大小和体积位置的函数。
