CAJ | 학술논문

目的分析每次在线CBCT图像引导下SBRT治疗原发和转移性肺癌的疗效及相关因素.方法回顾2009-2013年间采用SBRT治疗的36例肺肿瘤患者资料,包括原发肺癌24例、转移性肺癌12例.42个病灶中85.7％的BED10≥100 Gy.每次照射前采用CBCT扫描后采用在线自动和或手动配准使CBCT上肿瘤落入PTV、PGTV内,不设定摆位阈值,移床校正后进行照射.结果全组1、2、3年样本数分别为36、29、26例.1、2、3年LC率分别为96％、89％、72％,CCS率分别为82％、74％、64％,OS率分别为78％、64％、53％.单因素分析未发现与LC率相关因素,多因素分析也未显示与OS率相关因素.单因素和多因素分析均显示只有肿瘤位置分类变量(中央型、周边型)与肿瘤特异生存相关,中央型与周边型病灶的CCS平均值、95％CI值分别为21.4、13.2 ～29.6个月与42.3、35.7 ～ 49.0个月(P =0.024).结论每次疗前在线图像引导SBRT在原发或转移性肺肿瘤均可取得满意LC率.
목적 분석매차재선CBCT도상인도하SBRT치료원발화전이성폐암적료효급상관인소.방법 회고2009-2013년간채용SBRT치료적36례폐종류환자자료,포괄원발폐암24례、전이성폐암12례.42개병조중85.7％적BED10≥100 Gy.매차조사전채용CBCT소묘후채용재선자동화혹수동배준사CBCT상종류락입PTV、PGTV내,불설정파위역치,이상교정후진행조사.결과 전조1、2、3년양본수분별위36、29、26례.1、2、3년LC솔분별위96％、89％、72％,CCS솔분별위82％、74％、64％,OS솔분별위78％、64％、53％.단인소분석미발현여LC솔상관인소,다인소분석야미현시여OS솔상관인소.단인소화다인소분석균현시지유종류위치분류변량(중앙형、주변형)여종류특이생존상관,중앙형여주변형병조적CCS평균치、95％CI치분별위21.4、13.2 ～29.6개월여42.3、35.7 ～ 49.0개월(P =0.024).결론 매차료전재선도상인도SBRT재원발혹전이성폐종류균가취득만의LC솔.
Objective To analyze the clinical efficacy of daily online cone-beam computed tomography (CBCT)-guided stereotactic body radiation therapy (SBRT) for primary and metastatic lung cancer and its related factors.Methods From May 2009 to May 2013,36 patients with lung cancer were treated with SBRT,including 24 patients with primary lung cancer and 12 patients with metastatic lung cancer.The biologically effective dose at 10 Gy was ≥ 100 Gy in 85.7％ of 42 lesions.Before each delivery,CBCT was acquired,and online automatic or manual registration was performed to make the tumors on CBCT within the planning target volume/primary gross tumor volume;the setup threshold was not set,and the couch was moved for correction.Results The 1-,2-,and 3-year sample sizes were 36,29,and 26,respectively.The 1-,2-,and 3-year local control (LC) rates were 96％,89％,and 72％,respectively.The 1-,2-,and 3-year cancer-specific survival (CCS) rates were 82％,74％,and 64％,respectively.The 1-,2-,and 3-year overall survival (OS) rates were 78％,64％,and 53％,respectively.Univariate analysis found no factors associated with LC.Multivariate analysis revealed no factors associated with OS.Both univariate and multivariate analyses showed that only tumor location (central type or peripheral type) was associated with CCS;the mean values (95％ confidence intervals) of CCS in patients with central-type and peripheral-type lesions were 21.4 months (13.2-29.6 months) and 42.3 months (35.7-49.0months),respectively (P=0.024).Conclusions Daily online image-guided SBRT for primary or metastatic lung cancer can lead to a satisfactory LC.