射波刀放射外科治疗肺部肿瘤的临床分析

Clinical analysis of Cyberknife stereotactic surgery for lung tumors

目的回顾性分析射波刀（cyberknife,CK）放射外科治疗肺部肿瘤的临床结果,评估CK治疗肺部肿瘤的安全性和有效性。方法 CK治疗肺肿瘤患者50例,男40例,女10例,年龄19~90岁,平均年龄为68岁。金标跟踪23例,肺跟踪27例。31例肺部肿瘤有明确的组织学诊断,19例无组织学诊断。30例患者曾接受过手术、化疗、放疗等综合治疗,20例患者未接受过任何治疗。结果 CK治疗3个月和6个月的肿瘤局部控制率均为100%,完全缓解（complete remission,CR）率分别为11.1%和21.1%。CK治疗最常见的不适反应为乏力,根据肿瘤放射治疗协作组（radiation therapy oncology gronp,RTOG）分类,Ⅰ级3例,Ⅱ级1例,无Ⅲ级以上毒性。金标植入引起患者气胸4例,占17.4%;RTOG分类Ⅰ级3例,Ⅱ级1例。结论 CK治疗肺部肿瘤是安全、有效的,可获得较好的肿瘤控制率,但远期效果还需要进一步随访。

Objective The aim of this study was to evaluate the safety and effectiveness of Cyberknife stereotactic surgery in the treatment of lung tumors by retrospectively analyzing the clinical results of the strategy.Methods Fifty patients,40 males and 10 females,and aged 19-90（means 68） years,were treated by Cyberknife stereotactic surgery for lung tumors,with real-time target tracking through fiducial marker implantation in 23 cases and X-sight lung synchrony in 27.Of the total number,31 had histologically proven cancer,and the other 19 did not undergo histological diagnosis;30 had been previously treated by surgery,radiotherapy and chemotherapy,and the others had not received any treatment.Results At 3 and 6 months,the rate of local tumor control was 100% for all the assessable patients,and that of complete remission was 11.1% and 21.1%,respectively.The common adverse event was fatigue during Cyberknife treatment.Based on the classification of the Radiation Therapy Oncology Group（RTOG）,grade-I toxicity was found in 3 cases,grade-II in 1,and grade-Ⅲ in none.Gold fiducial marker implantation resulted in 4 cases of pneumothorax,including 3 cases of grade I and 1 case of grade II.Conclusion Cyberknife stereotactic surgery is safe and effective for the treatment of lung tumors,which is corroborated by a preferable control rate,but its long-term effect has yet to be confirmed by longer follow-ups.