방사선종양학

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  • [Radiat Oncol.] Feasibility of stereotactic radiotherapy for lung lesions and conventional radiotherapy for nodal areas in primary lung malignancies.

    울산의대/ 김연주,김수산*

  • 출처
    Radiat Oncol.
  • 등재일
    2018 Jul 11
  • 저널이슈번호
    13(1):127. doi: 10.1186/s13014-018-1071-5.
  • 내용

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    Abstract
    BACKGROUND:
    Combined stereotactic body radiotherapy (SBRT) for lung lesions and conventional radiotherapy (CRT) for nodal areas may be more effective than CRT alone in patients with locally advanced lung cancer.

    METHODS:
    This study included 21 patients with small primary lung tumors distant from the regional nodal areas. The SBRT dose was 40-60 Gy in 4 fractions. CRT doses were 66 Gy in 30 fractions for non-small cell lung cancer and 52.5 Gy in 25 fractions for small cell lung cancer.

    RESULTS:
    The median follow-up duration was 12 months, and the median survival was 13 months. The 1 year overall survival, local recurrence-free survival, and distant metastasis-free survival rates were 60.5, 84.8, and 62.1%, respectively. Two patients experienced in-field local recurrence combined with out-field regional recurrence and/or distant failure. The major recurrence pattern was distant failure (crude incidence, 43%). Three patients aged ≥79 years experienced grade ≥ 3 acute radiation pneumonitis, and one also had idiopathic interstitial pneumonia.

    CONCLUSION:
    The combination of SBRT for the lung lesion and CRT for the nodal region seems to be effective and safe for lung malignancies. However, patients older in age and/or with underlying pulmonary disease require stricter lung dose constraints.

     


    Author information

    Kim YJ1, Kim SS2, Song SY1, Choi EK1.
    1
    Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
    2
    Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. watermountain@hanmail.net.

  • 키워드
    Lung cancer; Radiotherapy; Survival; Toxicity
  • 편집위원

    Mediastinal LNs와 멀리 떨어진 primary small lesion을 통상적인 방법으로 모두 포함하여 방사선치료 진행시 entire lung에 방사선이 조사되기 때문에 radiation pneumonitis risk가 높고, 선량 제한으로 local failure risk도 공존하는데, primary lesion에는 SBRT를 시행하고 mediastinal nodal area는 통상적인 분할치료를 진행하는 최신 치료 기법을 활용함으로써 효과적인 치료 결과를 보여준 본 연구는 해당 환자 진료시 치료 방법 설계에 많은 도움이 될 것을 기대한다.

    2018-08-24 15:59:07

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