Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant ...Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.展开更多
目的评价立体定向放射治疗联合厄洛替尼治疗晚期非小细胞肺癌的疗效和不良反应。方法 42例晚期非小细胞肺癌患者均经病理组织学或细胞学检查确诊。所有病例于2008-08至2012-08均行伽马刀治疗后,开始口服靶向药物厄洛替尼,100～150 mg/d...目的评价立体定向放射治疗联合厄洛替尼治疗晚期非小细胞肺癌的疗效和不良反应。方法 42例晚期非小细胞肺癌患者均经病理组织学或细胞学检查确诊。所有病例于2008-08至2012-08均行伽马刀治疗后,开始口服靶向药物厄洛替尼,100～150 mg/d,进食1 h前或进食2 h后服药;连续不间断服药至少2个月。伽马刀治疗结束至少1个月后评价疗效及不良反应。结果全组42例患者客观有效率(response rate,RR)19.9%(8/42),疾病控制率(disease control rate,DCR)61.9%(26/42);中位疾病进展时间(the median time to disease progression,TTP)5.2个月,中位生存期(median survival time,MST)11.5个月。不良反应多为Ⅰ/Ⅱ度,Ⅲ/Ⅳ度较少。结论采用γ-立体定向放疗结合靶向药物厄洛替尼对晚期非小细胞肺-癌进行治疗效果较好,不良反应轻微,多数患者能耐受治疗。展开更多
目的评估立体定向放射治疗技术(stereotactic body radiotherapy,SBRT)治疗70岁及以上老年Ι期肺癌患者的不良反应和疗效。方法根据入选标准收集2011年6月至2013年6月期间的30例Ⅰ期肺癌老年患者,所有患者使用螺旋断层放疗系统(tomother...目的评估立体定向放射治疗技术(stereotactic body radiotherapy,SBRT)治疗70岁及以上老年Ι期肺癌患者的不良反应和疗效。方法根据入选标准收集2011年6月至2013年6月期间的30例Ⅰ期肺癌老年患者,所有患者使用螺旋断层放疗系统(tomotherapy system,TOMO)配合四维计算机断层扫描(4-dimensional computed tomography,4D-CT)呼吸时相融合控制技术进行SBRT治疗。周围型病灶为50 Gy/5F,中央型病灶为60 Gy/10F。放疗结束后随访观察不良反应和疗效。结果中位随访时间为28.3个月。1年和2年局部控制率(local control rate,LCR)均为77.9%,1年和2年无进展生存率(progression-free survival,PFS)分别为66.7%和56.4%,1年和2年总生存率(overall survival,OS)分别为96.7%和92.1%。2级和3级急性放射性肺炎的发生率分别为6.6%和3.3%。中央型与周围型病灶相比,治疗效果及不良反应差异无统计学意义。结论使用TOMO配合4D-CT呼吸时相融合控制技术对老年Ⅰ期肺癌患者进行SBRT治疗,患者耐受良好,对周围型和中央型肺癌均可取得较好的LCR和OS,是一种安全有效的治疗手段。展开更多
Unlike conventional radiation therapy, stereotactic radiation therapy(SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. Th...Unlike conventional radiation therapy, stereotactic radiation therapy(SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs(spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.展开更多
文摘Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.
文摘目的评价立体定向放射治疗联合厄洛替尼治疗晚期非小细胞肺癌的疗效和不良反应。方法 42例晚期非小细胞肺癌患者均经病理组织学或细胞学检查确诊。所有病例于2008-08至2012-08均行伽马刀治疗后,开始口服靶向药物厄洛替尼,100～150 mg/d,进食1 h前或进食2 h后服药;连续不间断服药至少2个月。伽马刀治疗结束至少1个月后评价疗效及不良反应。结果全组42例患者客观有效率(response rate,RR)19.9%(8/42),疾病控制率(disease control rate,DCR)61.9%(26/42);中位疾病进展时间(the median time to disease progression,TTP)5.2个月,中位生存期(median survival time,MST)11.5个月。不良反应多为Ⅰ/Ⅱ度,Ⅲ/Ⅳ度较少。结论采用γ-立体定向放疗结合靶向药物厄洛替尼对晚期非小细胞肺-癌进行治疗效果较好,不良反应轻微,多数患者能耐受治疗。
文摘Unlike conventional radiation therapy, stereotactic radiation therapy(SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs(spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.
