射波刀治疗早期周围型非小细胞肺癌的疗效及预后分析  

Efficacy and prognostic analysis of Cyberknife treatment for peripheral non-small cell lung cancer in early stage

作　　者：邓丽君 潘雪峰[2] 刘佳[2] 郑国宝 Deng Lijun;Pan Xuefeng;Liu Jia;Zheng Guobao(Xinxiang Medical University,Henan Xinxiang 453000,China;No.150 Central Hospital of PLA,Henan Luoyang 471031,China)

机构地区：[1]新乡医学院,河南新乡453000 [2]解放军第150中心医院,河南洛阳471031

出　　处：《现代肿瘤医学》2020年第5期766-770,共5页Journal of Modern Oncology

摘　　要：目的:评价射波刀治疗早期周围型非小细胞肺癌的疗效及预后影响因素。方法:选取2010年10月至2016年9月期间我院射波刀治疗的Ⅰ/Ⅱ期周围型肺癌患者46例,其中Ⅰ期11例,Ⅱ期35例。照射总剂量为36~60 Gy(中位剂量为48 Gy),64%~85%等剂量线作为处方剂量包绕PTV,分割次数为3~12次,1日1次,每周5次。结果:治疗后1~94个月随访所有患者,近期疗效评价显示患者的总有效率和控制率分别为84.8%和93.5%。所有患者的局部中位无进展生存期(progression-free survival,PFS)和总的中位生存期(overall survival,OS)分别为40.0个月(95%CI:35.9~54.9)和43.0个月(95%CI:40.1~57.3),1年的局部控制率为91.3%,1年、3年和5年生存率分别为91.3%、58.5%和26.3%。治疗过程中及治疗后无Ⅱ级以上放射性肺炎及其它严重毒副反应发生。Cox模型多因素分析表明肿瘤靶区体积(gross target volume,GTV)和生物等效剂量(biologic effective dose,BED)是患者总生存时间的独立影响因子。结论:射波刀治疗对于早期周围型肺癌的患者是一项安全有效的治疗方法,尤其对于病灶较小的Ⅰ期非小细胞肺癌患者可能拥有比手术更高的临床获益率。Objective:To evaluate the efficacy and prognostic factors of Cyberknife treatment for peripheral non-small cell lung cancer(NSCLC)in early stage.Methods:46 patients with early stage NSCLC(including 11 cases of stageⅠpatients and 35 cases of stageⅡpatients)were treated with Cyberknife from October 2010 to September 2016 in our hospital.The total dose of irradiation was 36~60 Gy,and the PTV was covered by the 64%~85%isodose line.The total number of therapy was 3~12 times,and all patients were treated with irradiation once a day and five times a week.Results:All patients were followed up from 1 month to 94 months after treatment.Short-term efficacy results showed that the efficient rate and the control rate were 84.8%and 93.5%,respectively.The local median progression-free survival(PFS)was 40.0 months(95%CI:35.9~54.9),and the median overall survival(OS)was 43.0 months(95%CI:40.1~57.3).The local control rate for one year was 91.3%.The 1-year,3-year and 5-year survival rates were 91.3%,58.5%and 26.3%,respectively.There was no serious side effect during or after treatment in all patients.Multivariate analysis of Cox model showed that gross target volume(GTV)and biologic effective dose(BED)were independent prognostic indicators of OS in patients with early stage NSCLC.Conclusion:Cyberknife is an efficient and safe option for early stage NSCLC,especially for stageⅠpatients with small lesion,which may achieve a better clinical results than surgery.

关 键 词：早期周围型非小细胞肺癌 立体定向放射治疗 射波刀 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]