摘要
目的:探讨采用射波刀(CyberKnife)立体定向放射治疗技术治疗70岁以上老年早期肺癌患者的有效性和安全性。方法:回顾性分析天津医科大学附属肿瘤医院放疗科2006年11月至2010年9月间34例不能手术的老年早期肺癌患者(T_1N_0M_020例,T_2N_0M_014例),中位年龄78(70~88)岁,18例患者采用肿瘤内植入1~2枚金标的呼吸同步追踪技术(Synchrony),16例患者采用椎体追踪技术(X-Sight)。处方剂量45~60 Cy,中位剂量60 Gy,分3~6次给予。结果:25例病变完全缓解(73.5%),9例部分缓解(26.5%)。中位随访期29(11~59)个月,原发肿瘤局部控制率97.1%,1、2、3年无进展生存率分别为85.3%、81.6%、70.0%,总生存率分别为97.1%、86.6%、80.0%。31例患者(91.1%)出现治疗后的轻度乏力,15例患者(44.1%)发生Ⅰ~Ⅱ级放射性肺炎,未发现Ⅲ级及以上的不良反应。1例患者(2.9%)在经胸腔穿刺植入金标后发生严重气胸,经胸腔闭式引流后缓解。结论:射波刀立体定向放射治疗技术疗效确切,不良反应轻,为无法手术的老年早期肺癌患者的较好选择。
Objective: To evaluate the toxicity and efficacy of CyberKnifeR stereotactic radiotherapy in patients with early lung cancer aged over 70 years. Methods: The data of 34 inoperable elderly patients with early lung cancer ( 20 with T1 and 14 with T2 tu- mors ) from November 2006 to September 2010 were retrospectively reviewed. Among them, 18 were treated with the SynchronyR Re- spiratory Tracking System, which requires the implantation of 1-2 gold markers. The other 16 patients were treated with the X-sight~ technology. A total dose of 45-60 Gy ( median of 60 Gy ) was delivered in 3-6 fractions. Results: Complete response was achieved in 25 of the 34 patients ( 73.5% ), and partial response was achieved in the other 9 ( 26.7% ). At a median follow-up of 29 months, the pri- mary tumor control rate was 97.1%. The one-, two-, and three-year disease-free survival rates were 85.3%, 81.6%, and 70%, respective- ly. The one-, two-, and three-year overall survival rates were 97.1%, 86.6%, and 80%, respectively. Slight fatigue was reported in 31 of the 34 patients ( 91.1% ). Grades I and II radiation pneumonitis were observed in 15 of the 34 patients ( 44.1% ). Grade III radiation pneumonitis was not observed. Pneumothorax requiring tube thoracostomy occurred in one patient ( 2.9% ) following CT-guided fidu- cial placement. Conclusion: CyberKnife~ stereotactic radiotherapy is an effective therapeutic modality for elderly patients with early lung cancer. This therapy can provide a high local-control rate for primary tumors and has minimal toxicity.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2012年第15期1119-1122,共4页
Chinese Journal of Clinical Oncology
关键词
老年
早期肺癌
立体定向放射治疗
射波刀
Elderly patient
Early lung cancer
Stereotactic radiotherapy
CyberKnifeR