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射波刀治疗周围型非小细胞肺癌临床分析
方芳,居小萍*,张火俊,卢明智,陈樱,于春山,曹洋森,王晓艳,刘永明,张晓青
0
(第二军医大学长海医院放射治疗科, 上海 200433
*通信作者)
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。
关键词:  射波刀  肺肿瘤  周围型肺癌  非小细胞肺癌  立体定向放射治疗
DOI:10.16781/j.0258-879x.2016.01.0098
投稿时间:2015-03-26修订日期:2015-04-24
基金项目:
Cyberknife radiosurgery treatment of peripheral non-small cell lung cancer: clinical analysis
FANG Fang,JU Xiao-ping*,ZHANG Huo-jun,LU Ming-zhi,CHEN Ying,YU Chun-shan,CAO Yang-seng,WANG Xiao-yan,LIU Yong-ming,ZHANG Xiao-qing
(Department of Radiation Oncology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.)
Abstract:
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.
Key words:  cyberknife  lung neoplasms  peripheral lung cancer  non-small-cell lung carcinoma  stereotactic radiotherapy