局部无进展生存评价射波刀治疗外周型肺肿瘤局部疗效价值

Value of local progression-free survival for evaluating local outcome of peripheral lung cancer treatedby cyberknife

目的探讨局部无进展生存（LPFS）评价射波刀治疗外周型肺肿瘤局部远期疗效的价值。方法同顾分析射波刀治疗肺转移瘤或原发瘤患者81例资料，其中原发肺肿瘤43例43个病灶，肺转移瘤38例47个病灶。58例63个病灶接受60Gy分3次治疗（20Gy／次），23例27个病灶接受54Gy分3次治疗（18Gy／次）。以近期疗效和LPFS为观察指标，Logistic法分析LPFS对局部远期疗效的预测作用。结果近期疗效评价后全组63％病灶需后续复查中再评价，随时间延长需冉评价病灶逐渐减少，且以6个月至2年减少最为迅速。再次疗效评价对后续随访疗效评价均有预测作用，但随时间延长预测作用逐渐减弱。结论LPFS是射波刀治疗局部有效的早期原发肺肿瘤或肺转移瘤可推荐的局部疗效评价指标，且对局部远期疗效也有预测价值。

Objective To investigate the value of local progression-free survival （LPFS） for evaluating the local long-term outcome of peripheral lung cancer treated by eyberknife. Methods Retrospective analysis was performed on the clinical records of 81 cyberknife-treated lung cancer patients （90 loci ） , including 43 primary lung cancer patients （43 foei ） and 38 metastatic lung cancer patients （47 loci）. Of all the patients, 58（63 loci） were treated at a dose of 60 Gy/3 fractions （20 Gy/fraetion）, and 23（27 foci） at a dose of 54 Gy/3 fractions （18 Gy/fraction）. The short-term treatment outcome and LPFS were used as the indices for observation;a logistic regression was used for analyzing the predictive value of LPFS for local long-term treatment outcome. Results After the evaluation of short-term treatment outcome, 63% of all the foci needed further evaluation. As the follow-up lasted, the number of loci which needed further evaluation decreased, most rapidly during O. 5--2 years after treatment. Re-evaluation results had predictive value for the treatment outcome in the subsequent follow-up, but the predictive value declined as the follow-up lasted. Conclusions LPFS is a recommendable index for evaluating the local outcome of primary or metastatic lung cancer treated by cyberknife, and it also has predicative value for local long-term treatment outcome.