Outcomes Following Stereotactic Body Radiotherapy with Intensity-Modulated Therapy versus Three-Dimensional Conformal Radiotherapy in Early Stage Non-Small Cell Lung Cancer.

IF 5.1 Q1 ONCOLOGY
Lung Cancer: Targets and Therapy Pub Date : 2019-12-20 eCollection Date: 2019-01-01 DOI:10.2147/LCTT.S235713
Michael Mix, Sean Tanny, Tamara Nsouli, Ryan Alden, Rishabh Chaudhari, Russell Kincaid, Paula F Rosenbaum, Jeffrey A Bogart, Paul Aridgides
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引用次数: 3

Abstract

Introduction: The treatment techniques used for stereotactic body radiation therapy (SBRT) for early-stage lung cancer continue to evolve. In this study, clinical outcomes following SBRT were evaluated according to the use of either 3D conformal radiotherapy (3DCRT) or intensity-modulated radiation therapy (IMRT).

Patients and methods: Patients with stage I NSCLC who received SBRT from 2007 to 2015 were retrospectively reviewed. Disease control and survival were assessed using Kaplan-Meier estimates. Dosimetric analyses for target dose heterogeneity and coverage were performed.

Results: A total of 297 patients with 351 lesions were included. 3DCRT was used in 52% and IMRT in 48%. IMRT was utilized at a higher rate in more recent years. The most common regimens were 48 Gy in 4 fractions and 54-60 Gy in 3 fractions. With a median follow up of 22.7 months, there were 17 local failures for a crude relapse rate of 5.7%. Local failure did not differ in patients treated with 3DCRT and IMRT (4.9% vs 6.5%, p=0.573). Mean dose to gross tumor volume (GTV) as a percent of prescription dose was higher with 3DCRT compared with IMRT (107.7% vs 103.6%, p < 0.0001). Tumor stage, histology, and SBRT regimen did not correlate with local tumor control. Overall survival for the entire population approximated 72% at 2 years. Treatment was well tolerated with 6 documented grade 3+ events.

Conclusion: In this single-institution cohort of SBRT for early-stage NSCLC, there was no discernible difference in clinical outcomes between those treated with 3DCRT and IMRT.

Abstract Image

Abstract Image

Abstract Image

立体定向体放疗加调强治疗与三维适形放疗治疗早期非小细胞肺癌的疗效比较。
用于早期肺癌立体定向放射治疗(SBRT)的治疗技术在不断发展。在这项研究中,根据使用3D适形放疗(3DCRT)或调强放疗(IMRT)来评估SBRT后的临床结果。患者和方法:回顾性分析2007 - 2015年接受SBRT治疗的I期NSCLC患者。采用Kaplan-Meier估计法评估疾病控制和生存率。对靶剂量的异质性和覆盖率进行了剂量学分析。结果:共纳入297例患者,351个病灶。3DCRT占52%,IMRT占48%。近年来,IMRT的使用率较高。最常见的治疗方案是48 Gy分4次,54-60 Gy分3次。中位随访22.7个月,局部失败17例,粗复发率5.7%。3DCRT和IMRT治疗的患者局部失败无差异(4.9% vs 6.5%, p=0.573)。3DCRT的平均总肿瘤体积(GTV)占处方剂量的百分比高于IMRT (107.7% vs 103.6%, p < 0.0001)。肿瘤分期、组织学和SBRT治疗方案与局部肿瘤控制无关。整个人群2年的总生存率约为72%。治疗耐受性良好,有6例3+级事件记录。结论:在SBRT治疗早期NSCLC的单机构队列中,3DCRT和IMRT治疗的临床结果没有明显差异。
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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来源期刊
CiteScore
8.10
自引率
0.00%
发文量
10
审稿时长
16 weeks
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