Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, Hungary.
Pathol Oncol Res. 2024 Feb 27;30:1611709. doi: 10.3389/pore.2024.1611709. eCollection 2024.
The treatment of early stage non-small cell lung cancer (NSCLC) has improved enormously in the last two decades. Although surgery is not the only choice, lobectomy is still the gold standard treatment type for operable patients. For inoperable patients stereotactic body radiotherapy (SBRT) should be offered, reaching very high local control and overall survival rates. With SBRT we can precisely irradiate small, well-defined lesions with high doses. To select the appropriate fractionation schedule it is important to determine the size, localization and extent of the lung tumor. The introduction of novel and further developed planning (contouring guidelines, diagnostic image application, planning systems) and delivery techniques (motion management, image guided radiotherapy) led to lower rates of side effects and more conformal target volume coverage. The purpose of this study is to summarize the current developments, randomised studies, guidelines about lung SBRT, with emphasis on the possibility of increasing local control and overall rates in "fit," operable patients as well, so SBRT would be eligible in place of surgery.
在过去的二十年中，早期非小细胞肺癌（NSCLC）的治疗已经取得了巨大的进展。尽管手术不是唯一的选择，但肺叶切除术仍然是可手术患者的金标准治疗方法。对于不能手术的患者，应提供立体定向体部放疗（SBRT），达到非常高的局部控制率和总生存率。通过 SBRT，我们可以用高剂量精确照射小而明确的病变。为了选择合适的分割方案，重要的是要确定肺部肿瘤的大小、定位和范围。新型和进一步发展的规划（轮廓指南、诊断图像应用、规划系统）和传递技术（运动管理、图像引导放疗）的引入导致副作用发生率降低，靶区覆盖更符合形状。本研究的目的是总结目前关于肺部 SBRT 的发展、随机研究、指南，重点是提高“合适”的可手术患者的局部控制率和总生存率的可能性，以便 SBRT 能够替代手术。
