Department of Radiation Oncology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain.
Clin Transl Oncol. 2024 Dec;26(12):3246-3251. doi: 10.1007/s12094-024-03557-7. Epub 2024 Jun 13.
To evaluate clinical outcomes after SABR in a cohort of early-stage non-small cell lung cancer (NSCLC) or pulmonary metastases in chronic obstructive pulmonary disease (COPD) patients with forced expiratory volume in the first second predicted (FEV1) ≤ 50%.
Retrospective single-center study was performed to analyze clinical outcomes and toxicities in COPD patients with severe lung dysfunction treated with SABR from 1st June 2015 to 31st October 2022.
Thirty four patients (forty locations) were enrolled for analysis. Median follow-up was 2.9 years. Median age was 73.5 years (range, 65.6-80.1). FEV1 was 38% (range, 28.2-50.0) prior to radiotherapy. Median overall survival (OS) was 41.1 months (95% CI 38.9-not reached). OS rates at 2-, 3-, and 5- years were 79%, 71%, and 36%, respectively. Cancer-specific survival rates at 2-, 3-, and 5- years were 96%, 96%, and 68%, respectively. Local control rates at 2-, 3-, and 5- years were 88%, 83%, and 83%, respectively. No grade 4 or 5 toxicity was observed. The most common acute toxicity was pneumonitis (38.2%), of which only 1 patient (2.9%) reported grade 3 acute toxicity.
Lung SABR in patients with poor pulmonary function may be effective with acceptable toxicity.
评估预测第一秒用力呼气量（FEV1）≤50%的慢性阻塞性肺疾病（COPD）患者早期非小细胞肺癌（NSCLC）或肺转移接受立体定向消融放疗（SABR）后的临床结果。
回顾性单中心研究分析了 2015 年 6 月 1 日至 2022 年 10 月 31 日，严重肺功能障碍的 COPD 患者接受 SABR 治疗的临床结果和毒性。
34 例（40 个部位）患者入组分析。中位随访时间为 2.9 年。中位年龄为 73.5 岁（范围，65.6-80.1）。放疗前 FEV1 为 38%（范围，28.2-50.0）。中位总生存期（OS）为 41.1 个月（95%CI 38.9-未达到）。2、3、5 年 OS 率分别为 79%、71%和 36%。2、3、5 年癌症特异性生存率分别为 96%、96%和 68%。2、3、5 年局部控制率分别为 88%、83%和 83%。未观察到 4 级或 5 级毒性。最常见的急性毒性是放射性肺炎（38.2%），其中仅 1 例（2.9%）患者报告了 3 级急性毒性。
肺 SABR 治疗肺功能差的患者可能有效，且毒性可接受。
