Pulmonary function testing after stereotactic body radiotherapy to the lung

被引：33

作者：

Bishawi, Muath ^{[1
]}

Kim, Bong ^{[2
]}

Moore, William H. ^{[3
]}

Bilfinger, Thomas V. ^{[1
]}

机构：

[1] Division of Cardiothoracic Surgery, Stony Brook University Medical Center, Stony Brook, NY

[2] Division of Radiology, Stony Brook University Medical Center, Stony Brook, NY

[3] Division of Radiation Oncology, Stony Brook University, Stony Brook, NY

来源：

International Journal of Radiation Oncology Biology Physics | 2012年 / 82卷 / 01期

关键词：

Non-small-cell lung cancer; Pulmonary function; Stereotactic body radiotherapy;

D O I：

10.1016/j.ijrobp.2011.01.037

中图分类号：

学科分类号：

摘要：

Purpose: Surgical resection remains the standard of care for operable early-stage non-small-cell lung cancer (NSCLC). However, some patients are not fit for surgery because of comorbidites such as chronic obstructive pulmonary disease (COPD) and other medical conditions. We aimed to evaluate pulmonary function and tumor volume before and after stereotactic body radiotherapy (SBRT) for patients with and without COPD in early-stage lung cancer. Methods and Materials: A review of prospectively collected data of Stage I and II lung cancers, all treated with SBRT, was performed. The total SBRT treatment was 60 Gy administered in three 20 Gy fractions. The patients were analyzed based on their COPD status, using their pretreatment pulmonary function test cutoffs as established by the American Thoracic Society guidelines (forced expiratory volume [FEV]% ≤50% predicted, FEV%/forced vital capacity [FVC]% ≤70%). Changes in tumor volume were also assessed by computed tomography. Results: Of a total of 30 patients with Stage I and II lung cancer, there were 7 patients in the COPD group (4 men, 3 women), and 23 in t he No-COPD group (9 men, 14 women). At a mean follow-up time of 4 months, for the COPD and No-COPD patients, pretreatment and posttreatment FEV% was similar: 39 ± 5 vs. 40 ± 9 (p = 0.4) and 77 ± 0.5 vs. 73 ± 24 (p = 0.9), respectively. The diffusing capacity of the lungs for carbon monoxide (DL CO) did significantly increase for the No-COPD group after SBRT treatment: 60 ± 24 vs. 69 ± 22 (p = 0.022); however, DL CO was unchanged for the COPD group: 49 ± 13 vs. 50 ± 14 (p = 0.8). Although pretreatment tumor volume was comparable for both groups, tumor volume significantly shrank in the No-COPD group from 19 ± 24 to 9 ± 16 (p < 0.001), and there was a trend in the COPD patients from 12 ± 9 to 6 ± 5 (p = 0.06). Conclusion: SBRT did not seem to have an effect on FEV 1 and FVC, but it shrank tumor volume and improved DL CO for patients without COPD. Copyright © 2012 Elsevier Inc. Printed in the USA. All rights reserved.

引用

页码：e107 / e110

页数：3

共 12 条

[1]

Hof H., Herfarth K.K., Munter M., Stereotactic single-dose radiotherapy of stage i non-small-cell lung cancer (NSCLC), Int J Radiat Oncol Biol Phys, 56, pp. 335-341, (2003)

[2]

Nagata Y., Takayama K., Matsuo Y., Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame, Int J Radiat Oncol Biol Phys, 63, pp. 1427-1431, (2005)

[3]

Le Q.T., Loo B.W., Ho A., Results of a phase i dose-escalation study using single-fraction stereotactic radiotherapy for lung tumors, J Thorac Oncol, 1, pp. 802-809, (2006)

[4]

Timmerman R.D., Park C., Kavanagh B.D., The North American experience with stereotactic body radiation therapy in non-small cell lung cancer, J Thorac Oncol, 2, (2007)

[5]

Nagata Y., Matsuo Y., Takayama K., Current status of stereotactic body radiotherapy for lung cancer, Int J Clin Oncol, 12, pp. 3-7, (2007)

[6]

Baumann P., Nyman J., Hoyer M., Stereotactic body radiotherapy for medically inoperable patients with stage i non-small cell lung cancer: A first report of toxicity related to COPD/CVD in a non-randomized prospective phase II study, Radiother Oncol, 88, pp. 359-367, (2008)

[7]

Baumann P., Nyman J., Hoyer M., Outcome in a prospective phase II trial of medically inoperable stage i non-small-cell lung cancer patients treated with stereotactic body radiotherapy, J Clin Oncol, 27, pp. 3290-3296, (2009)

[8]

Inoue T., Shimizu S., Rikiya O., Takeda A., Clinical outcomes of stereotactic body radiotherapy for small lung lesions clinically diagnosed as primary lung cancer on radiologic examination, Int J Radiat Oncol Biol Phys, 75, pp. 683-687, (2009)

[9]

McGarry R.M., Song G., Desrosiers P., Observation-only management of early stage, medically inoperable lung cancer, Chest, 121, pp. 1155-1158, (2002)

[10]

Stephans K.L., Djemil T., Reddy C., J Comprehensive analysis of pulmonary function test (PFT) changes after stereotactic body radiotherapy (SBRT) for stage i lung cancer in medically inoperable patients, Thorac Oncol, 4, pp. 838-844, (2009)

← 1 2 →