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目的研究射波刀治疗周围型非小细胞肺癌的近期疗效和不良反应,评估射波刀治疗周围型肺癌的安全性和有效性。方法对66例周围型非小细胞肺癌患者进行射波刀治疗,金标追踪25例,肺追踪35例,椎体追踪6例;65%~75%等剂量线覆盖计划靶区(planning target volume,PTV),总剂量为42~60Gy,分割次数4~6次,生物等效剂量(biological equivalent dose,BED)为71.4~150.0Gy。治疗后4~12周CT扫描评价近期疗效;随访时间为11~29个月,中位时间为18个月。结果全组患者完全缓解31例,部分缓解28例,稳定5例,疾病进展2例,有效率89.4%,肿瘤大小和BED是影响疗效的重要因素(P=0.019,P=0.007)。结论射波刀治疗周围型非小细胞肺癌安全、有效,可获得较好的肿瘤控制率,远期疗效需进一步随访。
Objective To study the short-term curative effect and adverse reactions of radiosurgery in the treatment of peripheral non-small cell lung cancer (NSCLC) and to evaluate the safety and effectiveness of radiosurgery in the treatment of peripheral lung cancer. Methods Sixty-six patients with peripheral non-small cell lung cancer were treated by radiosurgery. 25 cases were tracked by gold standard, 35 cases were followed by lung and 6 cases were followed by vertebral body. The planning target volume , PTV). The total dose was 42-60 Gy, the number of divisions was 4-6, and the biological equivalent dose (BED) was 71.4-150.0 Gy. After 4 to 12 weeks of treatment, CT scan evaluation of the short-term effect; follow-up time was 11 to 29 months, the median time was 18 months. Results The complete remission was achieved in 31 patients. The partial response was relieved in 28 cases, stabilized in 5 cases, and progressed in 2 cases. The effective rate was 89.4%. The size of the tumor and BED were the important factors influencing the efficacy (P = 0.019, P = 0.007). Conclusion It is safe and effective to treat peripheral non-small cell lung cancer with radiosurgery, and better tumor control rate can be obtained. Long-term curative effect needs further follow-up.