| 书阿克·努尔江,欧阳雯,李智军,等.立体定向放疗应用于肺寡转移灶的疗效与预后[J].中华放射医学与防护杂志,2019,39(4):255-261.Shuake·Nuerjiang,Ouyang Wen,Li Zhijun,et al.Clinical efficacy and prognosis of stereotactic body radiation therapy for pulmonary oligometastases[J].Chin J Radiol Med Prot,2019,39(4):255-261 |
| 立体定向放疗应用于肺寡转移灶的疗效与预后 |
| Clinical efficacy and prognosis of stereotactic body radiation therapy for pulmonary oligometastases |
| 投稿时间：2018-11-14 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.04.003 |
| 中文关键词: 肺寡转移灶 立体定向放射治疗 治疗结果 预后 |
| 英文关键词:Pulmonary oligometastases Stereotactic body radiation therapy Treatment outcome Prognosis |
| 基金项目:国家自然科学基金（81502308） |
|
| 摘要点击次数: 3433 |
| 全文下载次数: 2246 |
| 中文摘要: |
| 目的 分析立体定向放射治疗（stereotactic body radiation therapy，SBRT）应用于肺寡转移灶的疗效与预后。方法 回顾性分析2012-2018年本院SBRT肺寡转移患者104例临床资料，2015年12月前的患者采用调强放疗（intensity modulated radiation therapy，IMRT）技术行立体定向放射治疗，2015年12月后的患者采用螺旋断层放疗（helical tomotherapy，HT）技术行立体定向放射治疗，用Kaplan-Meier方法计算局部控制（local control，LC）、无进展生存期（progression-free survival，PFS）及总生存（overall survival，OS），Cox回归模型进行单因素与多因素分析，NCICTCAE V4.0标准评价放疗的不良反应。结果 1、2、3年的LC分别为86.6%、75.9%、72.3%，PFS分别为40.9%、28.4%、22.1%，OS分别为75.9%、53.2%、43.53%，中位OS为26.6个月。多因素分析显示原发肿瘤的病理类型、肺部结节的体积及SBRT治疗前癌胚抗原水平（carcino-embryonic antigen，CEA）为LC的独立预后因素（χ2=28.66，P<0.05），SBRT后的进展方式为OS的独立预后因素（χ2=40.01，P<0.05），HT-SBRT与IMRT-SBRT的LC及OS差异无统计学意义（P>0.05）；治疗的主要不良反应为放射性肺炎（25例，24.04%），2级及以上放射性肺炎的发生率不超过7%。结论 SBRT应用于肺寡转移灶的治疗局部控制率高，不良反应可接受，HT-SBRT与IMRT-SBRT的疗效相当，不良反应差异无统计学意义，可广泛应用于临床。 |
| 英文摘要: |
| Objective To analyze the clinical efficacy and prognosis of stereotactic body radiation therapy (SBRT) for pulmonary oligometastases. Methods Medical records of 104 patients with SBRT for pulmonary oligometastases in our hospital between 2012 and 2018 were retrospectively reviewed. SBRT was performed by intensity modulated radiation therapy (IMRT) technique before December 2015, and by helical tomotherapy (HT) technique in others. The local control (LC), progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox-regression was used for univariate analyses and multivariate analyses. The radiotherapy-related adverse events were evaluated by NCICTCAE V4.0. Results The 1-, 2-and 3-year LC rates were 86.6%, 75.9% and 72.3%, respectively. The 1-, 2-and 3-year PFS rates were 40.9%, 28.4% and 22.1%, respectively. The 1-, 2-and 3-year OS rates were 75.9%, 53.2% and 43.53%, respectively. The median OS time was 26.6 months. Multivariate analyses showed that the pathologic type of primary tumor, the volume of lung oligometastases and the carcino-embryonic antigen (CEA) level before SBRT were the independent prognostic factors of LC (χ2=28.66, P<0.05). The way of tumor progression after SBRT was the independent prognostic factor of OS (χ2=40.01, P<0.05). Meanwhile, there were no significant differences in the LC and OS between HT-SBRT and IMRT-SBRT. Radiation pneumonitis was the major adverse event of SBRT (n=25, 24.04%). Less than 7% patients experienced grade 2 and above radiation pneumonitis. Conclusions SBRT shows high local control rates and tolerable adverse events in the treatment of pulmonary oligometastases. There were no significant differences in the clinical efficacy and adverse events between HT-SBRT and IMRT-SBRT, which means they are all suitable for clinical application. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|