早期肺癌患者的机器人立体定向消融放疗：中期分析结果
Robotic Stereotactic Ablative Radiotherapy for Patients with Early-Stage Lung Cancer: Results of an Interim Analysis.
作者信息
Zygogianni Anna, Koukourakis Ioannis M, Georgakopoulos John, Armpilia Christina, Liakouli Zoi, Desse Dimitra, Ntoumas Georgios, Simopoulou Foteini, Nikoloudi Maria, Kouloulias Vassilis
机构信息
Radiation Oncology Unit, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Department of Clinical Radiation Oncology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece.
出版信息
Cancers (Basel). 2024 Sep 22;16(18):3227. doi: 10.3390/cancers16183227.
BACKGROUND/OBJECTIVES: Surgery is the primary treatment for early-stage lung cancer. Patients with medically inoperable lung carcinomas and patients who refuse to undergo surgery are treated with definite radiotherapy. Stereotactic ablative radiotherapy (SABR) is a compelling non-invasive therapeutic modality for this group of patients that confers promising results.
METHODS
We report an interim analysis of an ongoing trial. Eighty-one patients with medically inoperable early-stage (T1,2N0) lung cancer underwent SABR in our institution. SABR was delivered via the CyberKnife M6 robotic radiosurgery system. The endpoints of the analysis were treatment efficacy and tolerance.
RESULTS
There were no acute or late toxicities from the skin or the connective tissue of the thorax. A grade 2/3 lung injury of non-clinical significance was noted in 6% of patients, which was directly related to a higher biologically effective dose (BED) and larger irradiation lung volumes in both univariate and multivariate analyses. A local control (LC) was achieved in 100% of the patients at the first follow-up, and the projected 24-month local progression-free survival (LPFS) rate was 95%. The projected 24-month disease-specific overall survival (OS) was 94%.
CONCLUSIONS
High LC and OS rates can be achieved with SABR for early-stage lung cancer, with minimal toxicity. This study continues to recruit patients.
背景/目的：手术是早期肺癌的主要治疗方法。患有医学上无法手术的肺癌患者以及拒绝接受手术的患者接受确定性放疗。立体定向消融放疗（SABR）是针对这组患者的一种引人注目的非侵入性治疗方式，已取得了有前景的结果。
方法
我们报告了一项正在进行的试验的中期分析。81例医学上无法手术的早期（T1,2N0）肺癌患者在我们机构接受了SABR治疗。SABR通过射波刀M6机器人放射外科系统进行。分析的终点是治疗效果和耐受性。
结果
胸部皮肤或结缔组织未出现急性或晚期毒性反应。6%的患者出现了无临床意义的2/3级肺损伤，在单因素和多因素分析中，这与更高的生物学有效剂量（BED）和更大的照射肺体积直接相关。首次随访时100%的患者实现了局部控制（LC），预计24个月局部无进展生存率（LPFS）为95%。预计24个月疾病特异性总生存率（OS）为94%。
结论
SABR治疗早期肺癌可实现高LC率和OS率，且毒性极小。本研究仍在招募患者。
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