锥形束CT引导下应用SBRT治疗早期非小细胞肺癌疗效观察  

Clinical observation of stereotactic body radiation therapy guided by cone beam computed tomography for early non-small cell lung cancer

作　　者：张伟[1] 管峦[1] 吴承骏[1] 殷海涛[1] 胡翔[1] 丁纪[1] 

机构地区：[1]徐州市中心医院放射治疗科,江苏徐州221009

出　　处：《现代肿瘤医学》2018年第7期1044-1047,共4页Journal of Modern Oncology

摘　　要：目的:评价锥形束CT(cone beam CT,CBCT)引导下应用立体定向放射治疗(stereotactic body radiation therapy,SBRT)治疗早期非小细胞肺癌的近期疗效及毒副反应。方法:选取17例I期非小细胞肺癌患者接受CBCT引导下的SBRT胸部放疗,SBRT处方剂量DT 60 Gy/12 f,5次/周,95%以上计划靶区(PTV)满足处方剂量,90%等剂量线包含整个靶区,严格控制各危及器官剂量:双肺V_5<50%、V_(20)<20%,脊髓D_(max)<25 Gy,心脏D_(mean)<27 Gy等。每次照射前均行CBCT扫描并在线匹配、校准。结果:所有患者均完成放疗并随访3~24个月(中位随访期18个月),其中完全缓解(CR)4例,部分缓解(PR)12例,稳定(SD)1例,无进展患者,总有效率为94.1%。1年局部控制率和生存率分别为100%和100%。2年局部控制率和生存率分别为88.2%和82.3%。放疗期间未出现III级以上严重的放射性毒副反应。结论:应用CBCT引导下行SBRT治疗早期非小细胞肺癌,可显著提高其局部控制率和生存率,毒副反应较轻,但其远期疗效及晚期毒副反应仍待进一步随访观察。Objective：To evaluate the clinical effects and adverse reactions of stereotactic body radiation therapy （SBRT） guided by cone beam computed tomography （CBCT） for early non-small cell lung cancer （NSCLC）.Methods：Seventeen patients who received CBCT-guided SBRT were enrolled into the study.SBRT was prescribed of DT 60 Gy/12 f,5 times a week.More than 95% PTV meet the prescribed dose,90% of the prescription isodose line completed coverage of PTV,and strictly controled doses of OAR：The lung V5〈50%,V20〈20%,spinal cord Dmax〈25 Gy,heart Dmean〈27 Gy.All patients were matched and calibrated online daily by cone beam computed tomography before each treatment.Results：All patients completed the planned radiation and were followed up for 3 to 24 months,with a median of 18 months,with complete remission（CR） 4 cases,partial remission（PR） 12 cases,stable（SD） in 1 case,none progress desease.The total effective rate was 94.1%.The 1 year local control rate and survival rate was 100% and 100% respectively,and the 2-year local control rate and survival rate was 88.2% and 82.3% respectively.There was no serious radiotherapy adverse reaction during radiotherapy.Conclusion：Local control rate and survival rate can improve excellently using SBRT with daily online CBCT for early non-small cell lung cancer,and the adverse reaction is low,long-term response and late adverse reactions need further follow-up.

关 键 词：非小细胞肺癌 锥形束CT 立体定向放射治疗 近期疗效 

分 类 号：R734.2[医药卫生—肿瘤]