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肺寡转移瘤SBRT疗效及预后因素分析
李智军,李春阳,张俊红,王骁踊,张俊,王大奖,钟亚华,周福祥,周云峰,谢丛华
430071 武汉大学中南医院放化疗科 湖北省肿瘤医学临床研究中心
Clinical efficacy and prognostic factors of stereotactic body radiotherapy for pulmonary oligometastases
Li Zhijun, Li Chunyang, Zhang Junhong, Wang Xiaoyong, Zhang Jun, Wang Dajiang, Zhong Yahua, Zhou Fuxiang, Zhou Yunfeng, Xie Conghua
Department of Radiation and Medical Oncology,Zhongnan Hospital,Wuhan University,Hubei Key Laboratory of Tumor Biological Behaviors,Wuhan University,Wuhan 430071,China
Objective To evaluate the clinical efficacy and prognostic factors of stereotactic body radiotherapy (SBRT) for pulmonary oligometastases, and to further explore the patients most suitable for SBRT. Methods From 2012 to 2105, 51 patients with 76 oligometastatic lung tumors were treated with SBRT. In those patients, 27 had primary lung tumors and the others had extrapulmonary tumors. Seven patients had squamous cell carcinoma, thirty-five had adenocarcinoma, and the rest had other types of cancer. The patients received radiotherapy at a dose of 50 Gy in five fractions or 60 Gy in three fractions. Survival analysis was made by the Kaplan-Meier method. A multivariate analysis was made by the Cox model. Results The 1-and 2-year local control rates were 86%(65/76) and 80%(61/76), respectively. The 1-and 2-year overall survival (OS) rates were 80%(41/51) and 55%(28/51), respectively. The median survival time was 30(2-57) months, while the median progression-free survival time was 8(1-32) months. Twenty-one patients had grade 1 radiation pneumonitis (RP), while one patient had grade 2 RP. The multivariate analysis revealed that no more than 2 oligometastatic lung tumors, progression-free interval (PFI), and a performance score (PS) no higher than 1 were independent factors for OS (all P<0.05). Conclusions SBRT is effective and safe for treating pulmonary oligometastases. The number of oligometastatic lung tumors, PFI, and PS are independent prognostic factors for OS. Suitable patients and the appropriate timing of treatment are key to the efficacy of SBRT.
Li Zhijun,Li Chunyang,Zhang Junhong et al. Clinical efficacy and prognostic factors of stereotactic body radiotherapy for pulmonary oligometastases[J]. Chinese Journal of Radiation Oncology, 2017, 26(12): 1381-1384.
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