| 麻宁一,茅静芳,陈剑,蒋国梁,蔡昕,陆嘉德.质子碳离子笔形束扫描技术治疗Ⅰ期非小细胞肺癌的初步结果[J].中华放射医学与防护杂志,2017,37(5):321-326 |
| 质子碳离子笔形束扫描技术治疗Ⅰ期非小细胞肺癌的初步结果 |
| Preliminary clinical results after pencil beam scanning particle radiotherapy for stageⅠnon-small cell lung cancer |
| 投稿时间：2017-02-23 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.05.001 |
| 中文关键词: 非小细胞肺癌 放射治疗 质子 碳离子 笔形束扫描 |
| 英文关键词:Non-small cell lung cancer Radiotherapy Protons Carbon-ion Pencil beam scanning |
| 基金项目:上海市科学技术委员会科研项目（15411950103） |
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| 中文摘要: |
| 目的 在国内首次报道采用质子碳离子射线治疗Ⅰ期非小细胞肺癌（NSCLC）的近期疗效和不良反应。方法 2014年8月至2015年12月，共收治10例病理证实的Ⅰ期NSCLC患者。使用IONTRIS设备笔形束扫描技术，通过可以调节能量的点扫描、实现对靶区更加适形的目的，2~4个射野给予质子和碳离子放疗。根据肿瘤部位给予不同分割方式照射，4例周围型接受 50~70 GyE/10次放疗，3例中间型60~64 GyE/15~16次，3例中央型66~72 GyE/22~24次。结果 中位随访时间为18.1（11.9~28.1）个月，最后一次随访时患者均存活。10例患者局部控制率100%，其中6例患者完全缓解，3例部分缓解，1例疾病稳定；2例放疗后随访中出现远处转移。放疗开始3个月内，无3级及以上放疗相关急性不良反应发生。随访期内未观察到2级及以上的晚期不良反应。放疗后1和3~5个月肺功能（最大通气量、第1秒通气量及CO弥散量）与放疗前相比略有上升，差异无统计学意义（P>0.05）。结论 对Ⅰ期非小细胞肺癌患者，质子碳离子笔形束扫描技术治疗短期随访结果安全、有效。 |
| 英文摘要: |
| Objective To evaluate the safety and efficacy of proton and carbon-ion radiotherapy (RT) for stageⅠnon-small cell lung cancer (NSCLC) with pencil beam scanning technique.Methods From August 2014 to December 2015, 10 patients with stageⅠNSCLC who were inoperable or refused surgery were treated by proton +/- carbon-ion RT. Primary lesions were irradiated using 2-4 portals with 45-degree beams. A total dose of 50-70 GyE/10 fractions, 60-64 GyE/15-16 fractions, and 66-72 GyE/22-24 fractions were administered to patients based on tumor location (4 peripheral, 3 middle, and 3 central lesions, respectively). Results At the last follow-up in December 2016 with the median follow-up of 18.1 (11.9-28.1) months, local control was found in all patients per CT or PET/CT scanning(6 complete response, 3 partial response, and 1 stable disease). However, 2 patients with local control (1 partial response and 1 stable disease) experienced a distant failure at 8.7 and 24.9 months after RT, respectively. There was no RT-related Grade 3-5 toxicity in all patients. Grade 2 toxicities were only found in 2 patients (acute skin reaction and leucopenia, respectively). At 1, 3-5 months after RT, the pulmonary function tests showed a slightly increase in FVC, FEV1 and DLCO-sb compared with those before RT without statistical significance (P>0.05). Conclusions The particle RT using pencil beam scanning technique was safe, and yielded encouraging outcome for patients with stage I NSCLC who were inoperable or refused surgery. Further follow-up and prospective clinical studies are warranted in the future. |
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