射波刀治疗周围型非小细胞肺癌临床分析
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长海医院放疗科

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Cyberknife radiosurgery treatment of peripheral non-small cell lung cancer: clinical analysis
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    摘要:

    目的 研究射波刀治疗周围型非小细胞肺癌的近期疗效和不良反应,评估射波刀治疗周围型肺癌的安全性和有效性。 方法 对66例周围型非小细胞肺癌患者进行射波刀治疗,金标追踪25例,肺追踪35例,椎体追踪6例;65%~75%等剂量线覆盖计划靶区 (planning target volume,PTV),总剂量为42~60 Gy,分割次数4~6次,生物等效剂量 (biological equivalent dose,BED) 为71.4~150.0 Gy。治疗后4~12周CT扫描评价近期疗效;随访时间为11~29个月,中位时间为18个月。 结果 全组患者完全缓解31例,部分缓解28例,稳定5例,疾病进展2例,有效率89.4%,肿瘤大小和BED是影响疗效的重要因素 (P=0.019, P=0.007)。 结论 射波刀治疗周围型非小细胞肺癌安全、有效,可获得较好的肿瘤控制率,远期疗效需进一步随访。

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    Objective To study the short-time outcome and adverse effect of cyberknife in treatment of peripheral non-small cell lung cancer, so as to evaluate the safety and efficacy of cyberknife in treatment of peripheral lung cancer. Methods A total of 66 patients with peripheral non-small cell lung cancer completed their cyberknife radiosurgery, with real-time target tracking through fiducial marker implantation in 25 cases, X-sight lung synchrony in 35 cases, and X-sight spine tracking in 6 cases. Total prescribed dosage ranged from 42 to 60 Gy, with 4 to 6 fractions prescribed to the 65%-75% isodose lines for planning target volume. The biological effective dose (BED) was 71.4-150.0 Gy. The follow-up time was 11-29 months and the median time was 18 months. Results A total of 31 patients had complete radiographic responses, 28 had partial response, 5 patients had stable disease and 2 had progressive disease. The response rate was 89.4%. Tumor size and BED were the significant factors affecting the result of treatment (P=0.019, P=0.007). Conclusion Cyberknife radiosurgery treatment is effective and safe for peripheral non-small cell lung cancer. It can achieve satisfactory tumor control rate, while the long term outcome needs further follow-up.

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  • 收稿日期:2015-03-26
  • 最后修改日期:2015-04-24
  • 录用日期:2015-10-21
  • 在线发布日期: 2016-01-22
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