射波刀治疗早期非小细胞肺癌的疗效与观察
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摘要
目的探讨射波刀在早期非小细胞肺癌治疗中的疗效与安全性。方法回顾性分析海军总医院28例接受射波刀治疗的早期非小细胞肺癌患者(Ⅰ~Ⅱ期),处方剂量为28~52 Gy(中位剂量42.2 Gy),分3~7次给予。等剂量曲线水平为65%~87%(中位水平为80%)。结果疾病控制率96.4%,随访5~26个月(中位时间15个月),1年无进展生存率为96.4%,总生存率100%。发生Ⅰ~Ⅱ级乏力16例(57.1%),Ⅰ~Ⅱ级放射性肺炎5例(17.9%),无Ⅲ级及以上不良反应。结论射波刀治疗早期非小细胞肺癌局部控制率高、不良反应轻,可作为早期非小细胞肺癌患者的根治手段之一。
Objective To discuss the clinical efficacy and toxicity of the early non-small cell lung cancer treated by Cyberknife. Methods Retrospective analysis of 28 patients with early nonsmall cell lung cancer treated by Cyberknife in our department. A total dose of 28 ― 52 Gy( median of 42. 2 Gy) was delivered in 3 — 7 fractions. The median isodose curve was 80%( 65% — 87%).Results At a median follow-up of 15 months,the primary tumor local control rate was 96. 4%.The one-year disease-free survival rate was 96. 4%,and the one-year overall survival rate was100%. Patients with grade Ⅰ—Ⅱ radiation pneumonia were observed in 5( 17. 9%),grade Ⅰ—Ⅱfatigue in 16( 57. 1%),and grade Ⅲ adverse reactions not observed. Conclusion Cyberknife provide another radical treatment option for patients with early non-small cell lung cancer,which showed higher local control rate and lower adverse reaction.
Objective To discuss the clinical efficacy and toxicity of the early non-small cell lung cancer treated by Cyberknife. Methods Retrospective analysis of 28 patients with early nonsmall cell lung cancer treated by Cyberknife in our department. A total dose of 28 ― 52 Gy( median of 42. 2 Gy) was delivered in 3 — 7 fractions. The median isodose curve was 80%( 65% — 87%).Results At a median follow-up of 15 months,the primary tumor local control rate was 96. 4%.The one-year disease-free survival rate was 96. 4%,and the one-year overall survival rate was100%. Patients with grade Ⅰ—Ⅱ radiation pneumonia were observed in 5( 17. 9%),grade Ⅰ—Ⅱfatigue in 16( 57. 1%),and grade Ⅲ adverse reactions not observed. Conclusion Cyberknife provide another radical treatment option for patients with early non-small cell lung cancer,which showed higher local control rate and lower adverse reaction.
引文
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[8]Chen VJ,Oermann E,Vahdat S,et al.Cyber Knife with tumor tracking:an effective treatment for high-risk surgical patients with stageⅠnon-small cell lung cancer[J].Front Oncol,2012,2:9.
[9]Vahdat S,Oermann EK,Collins SP,et al.Cyber Knife radiosurgery for inoperable stageⅠA non-small cell lung cancer:18F-fluorodeoxyglucose positron emission tomography/computed tomography serial tumor response assessment[J].J Hematol Oncol,2010,3:6.
[10]Wang YY,Lin SX,Yang GQ,et al.Clinical efficacy of Cyber Knife combined with chemotherapy and hyperthermia for advanced non-small cell lung cancer[J].Mol Clin Oncol,2013,1(3):527-530.
[11]Shen ZT,Wu XH,Li B,et al.Clinical outcomes of Cyber Knife stereotactic body radiotherapy for peripheral stageⅠnon-small cell lung cancer[J].Med Oncol,2015,32(3):55.
[12]Wu VW,Tam KW,Tong SM.Evaluation of the influence of tumor location and size on the difference of dose calculation between Ray Tracing algorithm and Fast Monte Carlo algorithm in stereotactic body radiotherapy of nonsmall cell lung cancer using Cyber Knife[J].J Appl Clin Med Phys,2013,14(5):68-78.
[13]Swangsilpa T,Yongvithisatid P,Pairat K,et al.Preliminary experience of Cyber Knife treatment of primary non-small cell lung cancer[J].J Med Assoc Thai,2012,95(10):1335-1343.
[14]Agarwal R,Saluja P,Pham A,et al.The effect of Cyber-Knife therapy on pulmonary function tests used for treating nonsmall cell lung cancer:a retrospective,observational cohort pilot study[J].Cancer Manag Res,2012,4:347-350.
[15]Lv Y,Wang Z,Zhu X,et al.Preliminary effect of Cyberknife radiosurgery in the treatment of 31 patients with advanced non-small cell lung cancer[J].Zhongguo Fei Ai Za Zhi,2011,14(4):329-334.
[16]Davis JN,Medbery C 3rd,Sharma S,et al.Stereotactic body radiotherapy for early-stage non-small cell lung cancer:clinical outcomes from a National Patient Registry[J].J Radiat Oncol,2015,4(1):55-63.
[2]Boffa DJ.The revised stage classification system for primary lung cancer[J].Clin Chest Med,2011,32(4):741-748.
[3]Castelli J,Thariat J,Benezery K,et al.Feasibility and efficacy of cyberknife radiotherapy for lung cancer:early results[J].Cancer Radiother,2008,12(8):793-799.
[4]Xia T,Li H,Sun Q,et al.Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable stageⅠ/Ⅱnon-small-cell lung cancer[J].Int J Radiat Oncol Biol Phys,2006,66(1):117-125.
[5]Onishi H,Shirato H,Nagata Y,et al.Stereotactic body radiotherapy(SBRT)for operable stageⅠnon-small-cell lung cancer:can SBRT be comparable to surgery?[J].Int J Radiat Oncol Biol Phys,2011,81(5):1352-1358.
[6]Andratschke N,Zimmermann F,Boehm E,et al.Stereotactic radiotherapy of histologically proven inoperable stageⅠnon-small cell lung cancer:patterns of failure[J].Radiother Oncol,2011,101(2):245-249.
[7]Palma D,Lagerwaard F,Rodrigues G,et al.Curative treatment of stageⅠnon-small-cell lung cancer in patients with severe COPD:stereotactic radiotherapy outcomes and systematic review[J].Int J Radiat Oncol Biol Phys,2012,82(3):1149-1156.
[8]Chen VJ,Oermann E,Vahdat S,et al.Cyber Knife with tumor tracking:an effective treatment for high-risk surgical patients with stageⅠnon-small cell lung cancer[J].Front Oncol,2012,2:9.
[9]Vahdat S,Oermann EK,Collins SP,et al.Cyber Knife radiosurgery for inoperable stageⅠA non-small cell lung cancer:18F-fluorodeoxyglucose positron emission tomography/computed tomography serial tumor response assessment[J].J Hematol Oncol,2010,3:6.
[10]Wang YY,Lin SX,Yang GQ,et al.Clinical efficacy of Cyber Knife combined with chemotherapy and hyperthermia for advanced non-small cell lung cancer[J].Mol Clin Oncol,2013,1(3):527-530.
[11]Shen ZT,Wu XH,Li B,et al.Clinical outcomes of Cyber Knife stereotactic body radiotherapy for peripheral stageⅠnon-small cell lung cancer[J].Med Oncol,2015,32(3):55.
[12]Wu VW,Tam KW,Tong SM.Evaluation of the influence of tumor location and size on the difference of dose calculation between Ray Tracing algorithm and Fast Monte Carlo algorithm in stereotactic body radiotherapy of nonsmall cell lung cancer using Cyber Knife[J].J Appl Clin Med Phys,2013,14(5):68-78.
[13]Swangsilpa T,Yongvithisatid P,Pairat K,et al.Preliminary experience of Cyber Knife treatment of primary non-small cell lung cancer[J].J Med Assoc Thai,2012,95(10):1335-1343.
[14]Agarwal R,Saluja P,Pham A,et al.The effect of Cyber-Knife therapy on pulmonary function tests used for treating nonsmall cell lung cancer:a retrospective,observational cohort pilot study[J].Cancer Manag Res,2012,4:347-350.
[15]Lv Y,Wang Z,Zhu X,et al.Preliminary effect of Cyberknife radiosurgery in the treatment of 31 patients with advanced non-small cell lung cancer[J].Zhongguo Fei Ai Za Zhi,2011,14(4):329-334.
[16]Davis JN,Medbery C 3rd,Sharma S,et al.Stereotactic body radiotherapy for early-stage non-small cell lung cancer:clinical outcomes from a National Patient Registry[J].J Radiat Oncol,2015,4(1):55-63.