Clinical outcomes of stage I and IIA non-small cell lung cancer patients treated with stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system

被引：9

作者：

Katoh, Norio ^{[1
,2
]}

Soda, Itaru ^{[3
]}

Tamamura, Hiroyasu ^{[4
]}

Takahashi, Shotaro ^{[5
]}

Uchinami, Yusuke ^{[6
]}

Ishiyama, Hiromichi ^{[3
]}

Ota, Kiyotaka ^{[4
]}

Inoue, Tetsuya ^{[1
]}

Onimaru, Rikiya ^{[6
]}

Shibuya, Keiko ^{[5
]}

Hayakawa, Kazushige ^{[3
]}

Shirato, Hiroki ^{[2
,6
]}

机构：

[1] Hokkaido Univ Hosp, Dept Radiat Oncol, Kita Ku, North 14 West 5, Sapporo, Hokkaido, Japan

[2] Hokkaido Univ, Global Inst Collaborat Res & Educ GI CoRE, Global Stn Quantum Med Sci & Engn, Sapporo, Hokkaido, Japan

[3] Kitasato Univ, Dept Radiol & Radiat Oncol, Sch Med, Sagamihara, Kanagawa, Japan

[4] Fukui Prefectural Hosp, Dept Nucl Med, Fukui, Japan

[5] Yamaguchi Univ, Dept Therapeut Radiol, Grad Sch Med, Ube, Yamaguchi, Japan

[6] Hokkaido Univ, Dept Radiat Med, Grad Sch Med, Sapporo, Hokkaido, Japan

来源：

RADIATION ONCOLOGY | 2017年 / 12卷

关键词：

Stereotactic body radiotherapy; Non-small cell lung cancer; Real-time tumor-tracking radiotherapy; Gated radiotherapy; Image-guided radiotherapy; DOSE-RESPONSE RELATIONSHIP; RADIATION-THERAPY; ABLATIVE RADIOTHERAPY; GATED RADIOTHERAPY; RESPIRATORY MOTION; FIDUCIAL MARKERS; PNEUMONITIS; LOBECTOMY; SETUP; IRRADIATION;

D O I：

10.1186/s13014-016-0742-3

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To investigate the clinical outcomes of stage I and IIA non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system. Materials and methods: Patterns-of-care in SBRT using RTRT for histologically proven, peripherally located, stage I and IIA NSCLC was retrospectively investigated in four institutions by an identical clinical report format. Patterns-of-outcomes was also investigated in the same manner. Results: From September 2000 to April 2012, 283 patients with 286 tumors were identified. The median age was 78 years (52-90) and the maximum tumor diameters were 9 to 65 mm with a median of 24 mm. The calculated biologically effective dose (10) at the isocenter using the linear-quadratic model was from 66 Gy to 126 Gy with a median of 106 Gy. With a median follow-up period of 28 months (range 0-127), the overall survival rate for the entire group, for stage IA, and for stage IB + IIA was 75%, 79%, and 65% at 2 years, and 64%, 70%, and 50% at 3 years, respectively. In the multivariate analysis, the favorable predictive factor was female for overall survival. There were no differences between the clinical outcomes at the four institutions. Grade 2, 3, 4, and 5 radiation pneumonitis was experienced by 29 (10.2%), 9 (3.2%), 0, and 0 patients. The subgroup analyses revealed that compared to margins from gross tumor volume (GTV) to planning target volume (PTV) >= 10 mm, margins < 10 mm did not worsen the overall survival and local control rates, while reducing the risk of radiation pneumonitis. Conclusions: This multi-institutional retrospective study showed that the results were consistent with the recent patterns-of-care and patterns-of-outcome analysis of SBRT. A prospective study will be required to evaluate SBRT using a RTRT system with margins from GTV to PTV < 10mm.

引用

页数：10

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