Sarihan Sureyya, Tunc Sema Gozcu, Irem Zenciye Kiray, Kahraman Arda, Ocakoglu Gokhan
Department of Radiation Oncology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.
Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.
World J Oncol. 2024 Aug;15(4):711-721. doi: 10.14740/wjon1865. Epub 2024 Jul 5.
The aim of the study was to evaluate the efficacy of stereotactic body radiotherapy (SBRT) using the CyberKnife-M6 (CK-M6) with lung optimized treatment (LOT) module in patients with primary lung cancer and lung metastases.
Forty-two lesions from 35 patients were treated between 2019 and 2022. Four-dimensional computed tomography images were obtained when the patients were in a free breathing modality. Tracking modality was selected prospectively according to the visibility of the target. The median prescribed dose was 48 Gy in four fractions (fx) (28 - 55 Gy/1- 7 fx). The median age was 68 years (47 - 82 years), and 43% of cases were adenocarcinoma. The median lesion size was 15 mm (6 - 36 mm).
Complete, partial and stable responses were obtained as 26%, 62%, and 9.5% at a median of 2 months (1 - 6 months), and 35.5%, 47.5% and 5% at the 12th month evaluation, respectively. Grade 3 and higher toxicity was not observed in any case. The mean and 2-year overall survival (OS) was 31.5 months and 54%, and the local recurrence-free survival (LRFS) was 29.6 months and 51%, respectively. In univariate analysis, target lesion type, complete response (CR), and higher esophagus maximum dose were favorable factors for OS and LRFS (P < 0.05). The CR at 12th month evaluation remained significant in multivariate analysis in terms of OS (hazard ratio = 8.602, 95% confidence interval: 1.05 - 70.01; P = 0.044).
A mean LRFS of 29.6 months and OS of 31.5 months were obtained in patients with primary and metastatic lung cancer. With a median treatment time of 25 min, motion-managed strategy with CK-M6-LOT-based SBRT is an effective, safe, and comfortable treatment method for lung cancer.
本研究旨在评估使用带有肺部优化治疗（LOT）模块的射波刀M6（CK-M6）进行立体定向体部放疗（SBRT）对原发性肺癌和肺转移瘤患者的疗效。
2019年至2022年期间，对35例患者的42个病灶进行了治疗。患者在自由呼吸状态下获取四维计算机断层扫描图像。根据靶区的可视性前瞻性选择跟踪模式。中位处方剂量为48 Gy，分4次分割（fx）（28 - 55 Gy/1 - 7 fx）。中位年龄为68岁（47 - 82岁），43%的病例为腺癌。中位病灶大小为15 mm（6 - 36 mm）。
中位2个月（1 - 6个月）时，完全缓解、部分缓解和病情稳定的比例分别为26%、62%和9.5%；在第12个月评估时，分别为35.5%、47.5%和5%。未观察到任何3级及以上毒性反应。平均2年总生存期（OS）为31.5个月，生存率为54%；局部无复发生存期（LRFS）分别为29.6个月和51%。单因素分析中，靶病灶类型、完全缓解（CR）以及较高的食管最大剂量是OS和LRFS的有利因素（P < 0.05）。在多因素分析中，第12个月评估时的CR对于OS仍具有显著意义（风险比 = 8.602，95%置信区间：1.05 - 70.01；P = 0.044）。
原发性和转移性肺癌患者的平均LRFS为29.6个月，OS为31.5个月。基于CK-M6-LOT的SBRT运动管理策略中位治疗时间为25分钟，是一种有效、安全且舒适的肺癌治疗方法。
