Caivano D, Pezzulla D, Bonome P, Ricciardi C, Zuccoli P, Rotondi M, Sigillo R C, Serio M, Giannetti F, Molinari A, Menichelli C, Valeriani M, De Sanctis V, Fanelli A, Osti M F
Traslational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psycology, Sapienza University of Rome, Rome, Italy.
Radiation Oncology Unit, Responsible Research Hospital, Campobasso, 86100, Italy.
Clin Exp Metastasis. 2024 Dec 16;42(1):4. doi: 10.1007/s10585-024-10324-z.
Mediastinal and hilar lymphadenopathy (MHL) is a common pattern of cancer spread, particularly in lung disease. Recently, there has been interest in the use of SBRT for MHL, especially in the oligometastatic setting. The goal is to improve local control (LC) and to achieve shorter treatment durations to minimize systemic treatment interruptions. The primary endpoint of this study was local control (LC). The secondary endpoints were distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) and predictive factors of response. This is a retrospective study. It analyses a group of patients treated with SBRT for MHL with different primary tumours and histologies. From November 2007 to June 2023, we treated 159 MHL in 128 patients. The primary most represented was lung cancer. A single fraction was used in 16% of cases and multiple fractions in 84% of cases. The medium BED 10 was 75.06 Gy (range: 37-120 Gy). Actuarial LC rates at 1, 2 and 5 years were 80.0%, 78.8% and 75.2%. The actuarial DMFS rates at 1, 2 and 5 years were 43.9%, 34.1% and 14.1%, respectively. Actuarial PFS rates at 1, 2 and 5 years were 37.2%, 23.9% and 8.3%, respectively. Actuarial OS rates at 1, 2 and 5 years were 68.8%, 52.7% and 26.9%, respectively. SBRT may be an option for the treatment of MHL. In addition, achieving a complete response is one of the most important predictors of our endpoints, in addition to tumour burden and volume.
纵隔和肺门淋巴结肿大（MHL）是癌症扩散的常见模式，尤其是在肺部疾病中。最近，人们对使用立体定向体部放疗（SBRT）治疗MHL产生了兴趣，特别是在寡转移的情况下。目标是改善局部控制（LC）并实现更短的治疗时间，以尽量减少全身治疗的中断。本研究的主要终点是局部控制（LC）。次要终点是无远处转移生存期（DMFS）、无进展生存期（PFS）、总生存期（OS）以及反应的预测因素。这是一项回顾性研究。它分析了一组接受SBRT治疗的MHL患者，这些患者具有不同的原发肿瘤和组织学类型。从2007年11月到2023年6月，我们治疗了128例患者中的159例MHL。最主要的原发疾病是肺癌。16%的病例采用单次分割，84%的病例采用多次分割。平均等效生物剂量（BED）10为75.06 Gy（范围：37 - 120 Gy）。1年、2年和5年的精算LC率分别为80.0%、78.8%和75.2%。1年、2年和5年的精算DMFS率分别为43.9%、34.1%和14.1%。1年、2年和5年的精算PFS率分别为37.2%、23.9%和8.3%。1年、2年和5年的精算OS率分别为68.8%、52.7%和26.9%。SBRT可能是治疗MHL的一种选择。此外，除了肿瘤负荷和体积外，实现完全缓解是我们终点的最重要预测因素之一。
