Stereotactic body radiation therapy for early non-small cell lung cancer.

Frontiers of Radiation Therapy and Oncology Pub Date : 2010-01-01 Epub Date: 2009-11-24 DOI:10.1159/000262465
Frank Zimmermann, Jörn Wulf, Ingmar Lax, Yasushi Nagata, Robert D Timmerman, Igor Stojkovski, Branislav Jeremic
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引用次数: 19

Abstract

For patients with early stage non-small cell lung cancer (NSCLC) unsuitable for resection local high-dose radiotherapy is the treatment of choice. In modern series even with escalated conformal radiotherapy local control rates of about 55% remain disappointing. Within the last years, stereotactic radiotherapy has been shown an effective treatment approach for early stage malignant lung tumors, combining the accurate focal dose delivery by stereotactic techniques with the biological advantages of dose escalated hypofractionated radiotherapy. Typical treatment regimens include three to five fractions over 1-2 weeks or 1 single fraction as radiosurgery. With adequate staging procedures including FDG-PET-CT scan and a low probability of subclinical involvement of unsuspicious locoregional lymph nodes, the concept is to irradiate the primary T1/2 tumor alone. Recent data report local control rates of up to 90%, with favorable results especially for patients in good general condition. Less than 10% of all patients develop isolated tumor recurrences in regional lymph nodes. Three-year survival is significantly improved to more than 80% when biological effective doses of more than 100 Gy are applied to patients in good conditions. Systemic tumor recurrence still is a major problem, making an additional systemic chemotherapy interesting for selected patients after hSRT, such as those younger than 75 years.

立体定向放射治疗早期非小细胞肺癌。
对于不适合切除的早期非小细胞肺癌(NSCLC)患者,局部高剂量放疗是治疗的首选。在现代系列中,即使进行了升级的适形放疗,局部控制率约为55%仍然令人失望。近年来,立体定向放疗已被证明是早期恶性肺肿瘤的有效治疗方法,它将立体定向技术的准确局灶剂量传递与剂量递增的低分割放疗的生物学优势相结合。典型的治疗方案包括三到五次,1-2周或一次放射手术。有了适当的分期程序,包括FDG-PET-CT扫描和低概率的亚临床累及无可疑的局部区域淋巴结,概念是单独照射原发T1/2肿瘤。最近的数据显示,局部控制率高达90%,特别是对于一般情况良好的患者,效果良好。不到10%的患者在局部淋巴结发生孤立性肿瘤复发。如果病情良好的患者接受100戈瑞以上的生物有效剂量,三年生存率可显著提高至80%以上。全身性肿瘤复发仍然是一个主要问题,这使得在hSRT后选择额外的全身性化疗变得有趣,例如年龄小于75岁的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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