CAJ | 학술논문

目的探讨立体定向放疗(SBRT)不能手术Ⅰ+Ⅱ期非小细胞肺癌(NSCLC)患者的疗效及副反应.方法排除原发灶在中央支气管区域患者后30例病理诊断明确的NSCLC患者入组,其中T1+T2期(≤5 cm)28例,N0+M0期30例,T3期侵犯胸壁2例.由于生理状况或医源性疾病而不能手术.SBRT方式为50～70 Gy分10～11次12～15 d完成,处方剂量放在计划靶体积边缘.Kaplan Meier法计算局部控制率和生存率.结果 30例患者均完成治疗,疗后中位随访16个月,随访率为100%,其中随访满1、2年者分别为15、10例.完全缓解率为37%(11例),部分缓解为53%(16例),稳定率为3%(1例).2年局部控制率为94%,2年总生存率为84%,2年疾病相关生存率为90%.2级放射性肺炎发生率为23%(7例),无＞2级放射性肺炎发生,无一患者发生胸痛.结论采取50～70 Gy分10～11次12～15 d完成的SBRT早期NSCLC的2年局部控制率、疾病相关生存率较高,副反应较低,但最终试验结果有待进一步加大样本量评价.
목적 탐토입체정향방료(SBRT)불능수술Ⅰ+Ⅱ기비소세포폐암(NSCLC)환자적료효급부반응.방법 배제원발조재중앙지기관구역환자후30례병리진단명학적NSCLC환자입조,기중T1+T2기(≤5 cm)28례,N0+M0기30례,T3기침범흉벽2례.유우생리상황혹의원성질병이불능수술.SBRT방식위50～70 Gy분10～11차12～15 d완성,처방제량방재계화파체적변연.Kaplan Meier법계산국부공제솔화생존솔.결과 30례환자균완성치료,료후중위수방16개월,수방솔위100%,기중수방만1、2년자분별위15、10례.완전완해솔위37%(11례),부분완해위53%(16례),은정솔위3%(1례).2년국부공제솔위94%,2년총생존솔위84%,2년질병상관생존솔위90%.2급방사성폐염발생솔위23%(7례),무＞2급방사성폐염발생,무일환자발생흉통.결론 채취50～70 Gy분10～11차12～15 d완성적SBRT조기NSCLC적2년국부공제솔、질병상관생존솔교고,부반응교저,단최종시험결과유대진일보가대양본량평개.
Objective To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy(SBRT)in patients with medically inoperable stage Ⅰ/Ⅱ non-small cell lung cancer(NSCLC). Methods SBRT was applied to 30 patients, including clinically staged T1 ,T2(≤5cm)or T3(chest wall primary tumors only), N0, M0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response(CR), partial response(PR)and stable disease(SD)rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months(range,4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%)developed Grade 2 pneumonitis, no grade ＞ 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage Ⅰ / Ⅱ NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up.