REN Zheng-ting,CUI Di,REN Ye,DAI Zhuo-jie,SU Xiao-ming,FAN Jing-jing,SHEN Yu-long,MA Hui-zhen,WANG Zong-ye.Therapeutic efficacy of stereotactic radiotherapy with gamma knife on early-stage non-small-cell lung cancer and life quality of patients[J].Chinese Journal of Radiological Medicine and Protection,2012,32(6):621-625
Therapeutic efficacy of stereotactic radiotherapy with gamma knife on early-stage non-small-cell lung cancer and life quality of patients
Received:June 21, 2012  
DOI:10.3760/cma.j.issn.0254-5098.2012.06.015
KeyWords:Stereotactic radiotherapy (SBRT)  Non-small-cell lung cancer(NSCLC)  Local control rate  Overall survival  Quality of life
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Author NameAffiliationE-mail
REN Zheng-ting 100101 北京,安徽医科大学解放军第306临床学院 中国人民解放军第306医院放疗科  
CUI Di 总装备部总医院放疗科  
REN Ye 总装备部总医院放疗科  
DAI Zhuo-jie 总装备部总医院放疗科  
SU Xiao-ming 总装备部总医院放疗科  
FAN Jing-jing 总装备部总医院放疗科  
SHEN Yu-long 总装备部总医院放疗科  
MA Hui-zhen 总装备部总医院放疗科  
WANG Zong-ye 总装备部总医院放疗科 wangzye@163.com 
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Abstract::
      Objective To evaluate the therapeutic efficacy of stereotactic body radiotherapy (SBRT) with gamma knife on stageⅠ-Ⅱnon-small-cell lung cancer(NSCLC)and the quality of life of the patients undergoing this therapy. Methods Twenty NSCLC patients with the median age of 76, 10 at stage Ⅰ and 10 at stage Ⅱ who were unable or unwilling to undergo surgery were given SBRT with gamma knife at the doses of 3-6 Gy in 8-15 fractions, finished within 2 to 3 weeks. The prescription isodose line was 50%, the marginal dose was 39-56 Gy, the central dose was 78-112 Gy, and the total biologically effective dose was 51-83 Gy. The patients were observed after admission and followed up by chest CT 1, 3, 6, and 12 months after treatment until progressive disease or death. EORTC QLQ-LC43 questionnaire was used to investigate the changes in quality of life. Results The 20 patients were followed up for 24 (12-46) months.At six months after the treatment, the overall response rate was 80%, and the complete response rate was 35%. The 1,2 and 3-year local control rates were 100%,95% and 95%, respectively. The 1,2 and 3-year overall survival rates were 95%,80% and 50% respectively; The 1,2, and 3-year progression free survival rates were 85%,64% and 33%, respectively. The failure rate was 20% and the rate of progress within the planning target volume was 5%. No acute toxicity at grade 3 and over occurred in any patient during the treatment.15% of the patients developed grade 1-2 radiation pneumonia. Age, gender, pathologic index or not were weakly correlated with the overall survival. The emotional function was improved significantly after treatment(P<0.05), dyspnea and cough were improved at different degrees, however, not significantly. There were no significant changes in the physical function and symptoms, such as fatigue, lack of appetite, insomnia, etc. Conclusions Significantly improving the motional function and maintaining the quality of life, SBRT with gamma knife is effective for elderly NSCLC patients with high local control rate fair overall survival rate and few side effects.
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