目的:回顾性对比分析接受立体定向放疗(stereotactic body radiation therapy, SBRT)与调强放疗(intensity modulated radiation therapy, IMRT)治疗不适宜手术的Ⅰ期非小细胞肺癌患者的治疗效果及不良反应。方法:回顾性分析接受SBRT或I...目的:回顾性对比分析接受立体定向放疗(stereotactic body radiation therapy, SBRT)与调强放疗(intensity modulated radiation therapy, IMRT)治疗不适宜手术的Ⅰ期非小细胞肺癌患者的治疗效果及不良反应。方法:回顾性分析接受SBRT或IMRT放射治疗的Ⅰ期非小细胞肺癌患者45例,其中,接受SBRT治疗者21例,接受IMRT治疗者24例。比较二者的局部控制率、区域控制率、无进展生存率、远处转移控制率、肿瘤特异性生存率、总生存率及治疗相关不良反应。结果:SBRT组对比IMRT组显著提高了肿瘤的局部控制率、区域控制率以及无进展生存率。两者的1年、2年、3年肿瘤局部控制率分别为(100%、94.4%、63.2%) vs (87.0%、52.2%、39.1%)(P=0.037)。1年、2年、3年的区域控制率分别为(90.3%、63.3%、45.3%) vs (65.5%、37.4%、 23.3%)(P=0.041)。1年、2年、3年无进展生存率分别为(80.4%、48.5%、43.1%) vs (52.5%、21.9%、17.5%)(P=0.042)。而SBRT组在远处转移控制率,肿瘤相关性生存率及总生存率上对比IMRT组未体现出优势。两者的1年、2年、3年远处转移控制率分别为(85.2%、64.2%、48.1%) vs (91.4%、54.9%、41.2%)(P=0.803)。1年、 2年、 3年总生存率分别为(95.2%、81.0%、61.9%) vs (95.8%、83.3%、66.7%)(P=0.735)。1年、2年、3年肿瘤特异性生存率分别为(100%、89.5%、68.4%) vs (100%、90.9%、72.7%)(P=0.75)。治疗期间,两组间治疗相关不良反应相当,无明显差别。结论:在I期非小细胞肺癌的放射治疗上,SBRT对比IMRT具有提高局部控制率、区域控制率及无进展生存率的优势,但在远处转移控制率、肿瘤相关性生存率及总生存率上,两者无明显差别。临床医师可根据患者的不同状况选择适合的放射治疗方法。展开更多
Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological paramet...Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological parameters for a sample of 39 patients who underwent lung SBRT. Materials and Methods: For SBRT, a typical regimen of 50 Gy in 4 - 5 fractions results in local tumor control rates around 99.9%. We calculate dose volume histograms (DVHs) of targeted tumors and organs at risk for 39 patients. All patients received 4D imaging, and their internal treatment volumes (ITVs) were created by phase-based sorting of multiple CT datasets. Planning target volume (PTV) diameters ranged from 2.0 to 5.7 cm. The DVHs for the PTV and organs at risk were analyzed using a Biosuite algorithm to calculate the equivalent uniform dose (EUD), tumor control probability (TCP) via a Poisson model, and normal tissue complication probability (NTCP) via an LKB model. The radiobiological effects were analyzed by correlating EUD and TCP with PTV volumes. Results: The mean PTV volume was 31.60 ± 25.55 cc. The mean EUDs were 5.19 ± 2.84, 5.66 ± 4.95, 61.45 ± 29.18, 3.31 ± 5.92, 6.45 ± 5.18, and 12.22 ± 5.94 Gy for lungs, spinal cord, chest/ribs, heart, esophagus, and skin, respectively. On average, the heart had the lowest EUD and the chest/ribs had the highest (61.45 ± 29.18 Gy). The mean NTCPs were estimated at 3.75% ± 2.61%, 36.25% ± 36.42%, and 0.59% ± 1.48%, for the lungs, chest and esophagus, respectively. The NTCPs of spinal cord, heart, and skin were 0.00%. The mean TCP value was 99.72% ± 0.44%. The mean BED value for our study was 109.49 Gy. Conclusions: We have calculated radiobiological predictors based on DVHs for early-stage non-small cell lung cancer via SBRT. Our calculated predictors are compatible with previously published SBRT reports.展开更多
文摘目的:回顾性对比分析接受立体定向放疗(stereotactic body radiation therapy, SBRT)与调强放疗(intensity modulated radiation therapy, IMRT)治疗不适宜手术的Ⅰ期非小细胞肺癌患者的治疗效果及不良反应。方法:回顾性分析接受SBRT或IMRT放射治疗的Ⅰ期非小细胞肺癌患者45例,其中,接受SBRT治疗者21例,接受IMRT治疗者24例。比较二者的局部控制率、区域控制率、无进展生存率、远处转移控制率、肿瘤特异性生存率、总生存率及治疗相关不良反应。结果:SBRT组对比IMRT组显著提高了肿瘤的局部控制率、区域控制率以及无进展生存率。两者的1年、2年、3年肿瘤局部控制率分别为(100%、94.4%、63.2%) vs (87.0%、52.2%、39.1%)(P=0.037)。1年、2年、3年的区域控制率分别为(90.3%、63.3%、45.3%) vs (65.5%、37.4%、 23.3%)(P=0.041)。1年、2年、3年无进展生存率分别为(80.4%、48.5%、43.1%) vs (52.5%、21.9%、17.5%)(P=0.042)。而SBRT组在远处转移控制率,肿瘤相关性生存率及总生存率上对比IMRT组未体现出优势。两者的1年、2年、3年远处转移控制率分别为(85.2%、64.2%、48.1%) vs (91.4%、54.9%、41.2%)(P=0.803)。1年、 2年、 3年总生存率分别为(95.2%、81.0%、61.9%) vs (95.8%、83.3%、66.7%)(P=0.735)。1年、2年、3年肿瘤特异性生存率分别为(100%、89.5%、68.4%) vs (100%、90.9%、72.7%)(P=0.75)。治疗期间,两组间治疗相关不良反应相当,无明显差别。结论:在I期非小细胞肺癌的放射治疗上,SBRT对比IMRT具有提高局部控制率、区域控制率及无进展生存率的优势,但在远处转移控制率、肿瘤相关性生存率及总生存率上,两者无明显差别。临床医师可根据患者的不同状况选择适合的放射治疗方法。
文摘Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological parameters for a sample of 39 patients who underwent lung SBRT. Materials and Methods: For SBRT, a typical regimen of 50 Gy in 4 - 5 fractions results in local tumor control rates around 99.9%. We calculate dose volume histograms (DVHs) of targeted tumors and organs at risk for 39 patients. All patients received 4D imaging, and their internal treatment volumes (ITVs) were created by phase-based sorting of multiple CT datasets. Planning target volume (PTV) diameters ranged from 2.0 to 5.7 cm. The DVHs for the PTV and organs at risk were analyzed using a Biosuite algorithm to calculate the equivalent uniform dose (EUD), tumor control probability (TCP) via a Poisson model, and normal tissue complication probability (NTCP) via an LKB model. The radiobiological effects were analyzed by correlating EUD and TCP with PTV volumes. Results: The mean PTV volume was 31.60 ± 25.55 cc. The mean EUDs were 5.19 ± 2.84, 5.66 ± 4.95, 61.45 ± 29.18, 3.31 ± 5.92, 6.45 ± 5.18, and 12.22 ± 5.94 Gy for lungs, spinal cord, chest/ribs, heart, esophagus, and skin, respectively. On average, the heart had the lowest EUD and the chest/ribs had the highest (61.45 ± 29.18 Gy). The mean NTCPs were estimated at 3.75% ± 2.61%, 36.25% ± 36.42%, and 0.59% ± 1.48%, for the lungs, chest and esophagus, respectively. The NTCPs of spinal cord, heart, and skin were 0.00%. The mean TCP value was 99.72% ± 0.44%. The mean BED value for our study was 109.49 Gy. Conclusions: We have calculated radiobiological predictors based on DVHs for early-stage non-small cell lung cancer via SBRT. Our calculated predictors are compatible with previously published SBRT reports.
