肺寡转移瘤立体定向消融放疗的长期疗效观察

doi:10.3760/cma.j.cn113030-20200628-00323

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摘要目的评价立体定向消融放疗(SABR)在肺部寡转移瘤患者中的有效性和安全性。方法回顾性分析2011—2018年行SABR的 159例肺部转移瘤的患者资料,采用Kaplan-Meier方法计算局控率(LCR)和总生存(OS),并采用log-rank法单因素分析和Cox模型多因素分析。结果 159例患者共214个肺转移灶,中位随访时间43个月。1、3、5年LCR分别为90.1%、73.9%、65.8%;1、3、5年OS率分别为73.8%、43.6%、11.9%。单因素分析显示生物等效剂量(BED)≥100 Gy与高LCR相关(P=0.033)。多因素分析显示BED、原发灶来源是LCR的独立预后因素(P=0.023、0.043)。治疗期间所有患者未出现>3级不良反应。结论 SABR肺寡转移瘤安全有效,对于原发灶控制良好合并肺寡转移瘤的晚期患者,尤其来源于肺癌者,应积极给予SABR,放疗剂量应尽量选择BED≥100 Gy分割方案。

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	郑晓丽
	倪培赞
	孙亚楠
	叶柯
	范诚诚
	宋帅
	杨洋
	王楠
	王晓辉
	罗辉
	葛红

关键词 ：肿瘤,肺寡转移/立体定向消融放射疗法, 预后, 不良反应

Abstract：Objective To evaluate the efficacy and safety of stereotactic ablative radiotherapy (SABR) in patients with pulmonary oligometastases. Methods Clinical data of patients with pulmonary metastases treated with SABR from 2011 to 2018 were retrospectively analyzed. The local control rate (LCR) and overall survival (OS) were calculated by Kaplan-Meier method. log-rank test was used for univariate analysis and Cox's regression model for multivariate analysis. Results A total of 214 lung metastases were detected in 159 patients, and the median follow-up time was 43 months. The 1-, 3-and 5-year LCR were 90.1%, 73.9% and 65.8%, respectively. The 1-, 3-and 5-year OS were 73.8%, 43.6% and 11.9%, respectively. Univariate analysis showed that biological effective dose (BED)≥100 Gy was significantly correlated with LCR (P=0.033). Cox's multivariate analysis showed that BED and primary tumor source were the independent prognostic factors of LCR (P=0.023, P=0.043). No>grade 3 adverse events were observed in all patients during treatment. Conclusions SABR is a safe and effective treatment of lung oligometastases. SABR should be actively aDministered for pulmonary oligometastases, especially for those with lesions from lung cancer and the radiation dose should be selected as BED ≥100 Gy.

Key words： Neoplasm, lung oligometastases/stereotactic ablative radiotherapy Prognosis Adverse event

收稿日期: 2020-06-28

基金资助:国家自然科学基金面上项目(81773230)

通讯作者: 葛红,Email:gehong666@126.com

引用本文:

郑晓丽,倪培赞,孙亚楠等. 肺寡转移瘤立体定向消融放疗的长期疗效观察[J]. 中华放射肿瘤学杂志, 2021, 30(4): 343-347.

Zheng Xiaoli,Ni Peizan,Sun Yanan et al. Long-term therapeutic effect of stereotactic ablative radiotherapy for pulmonary oligometastasis[J]. Chinese Journal of Radiation Oncology, 2021, 30(4): 343-347.

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