Clinical outcomes of patients with malignant lung lesions treated with stereotactic body radiation therapy (SBRT) in five fractions
Tóm tắt
This study aims to investigate factors associated with local control and survival benefit of five-fraction stereotactic body radiation therapy (SBRT) for patients with lung malignancies. Patients with pathologically proven malignant lung lesions were treated using SBRT with prescribed dose of 40, 50, and 60 Gy in five fractions. The biologically effective dose assuming α/β ratios of 10 Gy (biologically equivalent doses (BED)10) was 72, 100, and 132 Gy. GTVall and lesion average BED(10), instead of gross tumor volume (GTV) and BED(10), were used in patients with multiple lesions in the overall survival-related factors analysis. GTVall was defined as the sum of all target GTV in treatment, and lesion average BED(10) was defined as the sum of all target BED(10) in treatment divided by number of targets. One hundred and three lesions were treated in 84 patients between June 2004 and June 2008, 69 lesions in 56 patients were eligible in this analysis. No severe (grade >2) toxicities were noted. Two-year local control rates were 92.6%, 100% for primary and recurrent/metastatic groups, respectively. There was no significant factor for local control in univariate and multivariate analyses. One- and 2-year overall survival rates were 96.2%, 45.5%, and 80.0%, 45.6% for the primary and recurrent/metastatic groups, respectively. Multivariate analysis showed that lesion average BED(10) ≥100 and GTVall <20 ml were favorable factors associated with overall survival (P = 0.021 and P = 0.029, respectively). SBRT in five fractions is safe and provides excellent local control for both primary and recurrent/metastatic lung malignancies. BED(10) and tumor volume were shown to be important for overall survival. Additional studies are needed to test the values of lesion average BED(10) and GTVall.
Tài liệu tham khảo
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