Fukuda Junki, Doi Hiroshi, Kono Atsushi, Inagaki Takaya, Hamazawa Naoko Ishida, Imamura Saori Tatsuno, Uehara Takuya, Inada Masahiro, Nakamatsu Kiyoshi, Hosono Makoto, Ishii Kazunari, Matsuo Yukinori
Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Department of Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Thorac Cancer. 2025 Jun;16(11):e70110. doi: 10.1111/1759-7714.70110.
This study aimed to assess the potential of prognostic factors including consolidation tumor ratio (CTR) on treatment outcomes in patients with clinical stage 0-IA non-small cell lung cancer (NSCLC) undergoing stereotactic body radiotherapy (SBRT).
The analysis included data of 63 patients with 67 lesions of clinical stage 0-IA NSCLC treated with SBRT. According to the Union for International Cancer Control 8th edition, the following tumor stages were observed: Tis, 3; T1mi, 2; T1a, 11; T1b, 29; and T1c, 22. The prescribed dose was 48 (range, 42-52) Gy in four fractions.
The median follow-up was 29.3 (range: 2.4-120.5) months. The five-year local control (LC), overall survival, and progression-free survival (PFS) rates were 89.4%, 60.3%, and 40.5%, respectively. Squamous cell carcinoma (Sq) and D < 125 Gy for planning target volume (PTV) were associated with a worse LC (p = 0.001 and 0.017, respectively). Patients with Sq, T1b-c, CTR > 0.25, PTV ≥ 30 cm tumors were associated with worse PFS than those with non-Sq, ≤ cT1a, CTR ≤ 0.25, PTV < 30 cm tumors (p = 0.049, 0.004, 0.038, and 0.004, respectively). No recurrences, metastases, or deaths were found in patients with CTR ≤ 0.25 (n = 5).
In patients with stage 0-IA lung cancer treated with SBRT, tumors classified as ≤ T1a showed a better PFS than T1b-c. NSCLC with a low CTR of ≤ 0.25 seemed to have a low risk of recurrence after SBRT.
本研究旨在评估包括巩固肿瘤比例（CTR）在内的预后因素对接受立体定向体部放疗（SBRT）的临床0-IA期非小细胞肺癌（NSCLC）患者治疗结果的影响。
分析纳入了63例接受SBRT治疗的67个临床0-IA期NSCLC病灶患者的数据。根据国际癌症控制联盟第8版，观察到以下肿瘤分期：Tis，3例；T1mi，2例；T1a，11例；T1b，29例；T1c，22例。处方剂量为48（范围42-52）Gy，分4次给予。
中位随访时间为29.3（范围：2.4-120.5）个月。5年局部控制（LC）率、总生存率和无进展生存率（PFS）分别为89.4%、60.3%和40.5%。鳞状细胞癌（Sq）和计划靶体积（PTV）的D＜125 Gy与较差的LC相关（分别为p = 0.001和0.017）。与非Sq、≤cT1a、CTR≤0.25、PTV＜30 cm的肿瘤患者相比，Sq、T1b-c、CTR＞0.25、PTV≥30 cm肿瘤的患者PFS较差（分别为p = 0.049、0.004、0.038和0.004）。CTR≤0.25的患者（n = 5）未发现复发、转移或死亡。
在接受SBRT治疗的0-IA期肺癌患者中，分类为≤T1a的肿瘤PFS优于T1b-c。CTR≤0.25的NSCLC在SBRT后复发风险似乎较低。
