방사선종양학

본문글자크기
  • [Thorac Cancer.] 폐전이 환자에서 정위체부방사선치료(SBRT)와 절제술 치료결과 비교 Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases.

    경상의대 / 이윤희, 강기문, 정배권*

  • 출처
    Thorac Cancer.
  • 등재일
    2018 Dec
  • 저널이슈번호
    9(12):1671-1679. doi: 10.1111/1759-7714.12880. Epub 2018 Oct 8.
  • 내용

    바로가기  >

    Abstract
    BACKGROUND:
    We compared the treatment outcomes of stereotactic body radiotherapy (SBRT) and metastasectomy in patients with pulmonary metastases.

    METHODS:
    Twenty-one patients received SBRT (total radiation doses 60 Gy in 3 fractions or 48 Gy in 4 fractions) and 30 underwent metastasectomy, most (93.3%) with wedge resection. The patients were followed for a median of 13.7 months. The tumor size in the SBRT group was larger than in the metastasectomy group (median 2.5 vs. 1.25 cm; P = 0.015). Patients with synchronous metastases were more likely to be treated with SBRT than with metastasectomy (P = 0.006).

    RESULTS:
    There was no significant difference in the local control rates of the treatment groups (P = 0.163). Progression-free survival (PFS) was longer in the metastasectomy than in the SBRT group (P = 0.02), with one and two-year PFS rates of 51.1% and 46% versus 23.8% and 11.9%, respectively. The one and two-year overall survival (OS) rates were 95% and 81.8% in the metastasectomy group and 79.5% and 68.2%, in the SBRT group, respectively. In multivariate analysis, synchronous metastasis was related to poor PFS, and tumor size was the most significant factor affecting OS. There were no significant differences in PFS and OS between treatment groups after dividing patients according to the presence or absence of synchronous metastases.

    CONCLUSIONS:
    SBRT is considered a suitable local modality against pulmonary metastases; however, patients with synchronous metastases are only likely to obtain a small benefit from local treatment with either SBRT or surgery.

     


    Author information

    Lee YH1,2, Kang KM2,3, Choi HS3, Ha IB1, Jeong H1,2, Song JH2,3, Jang IS4, Kim SH5, Lee JW6, Rhee DY7, Jeong BK1,2.
    1
    Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, South Korea.
    2
    Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
    3
    Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea.
    4
    Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, South Korea.
    5
    Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea.
    6
    Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, South Korea.
    7
    Department of Emergency Medicine, Hanmaeum General Hospital, Jeju, South Korea.

  • 키워드
    Local control; metastasectomy; pulmonary metastases; stereotactic body radiotherapy; survival
  • 연구소개
    초기 폐암에 대해서는 외과적 절제와 방사선수술의 치료 결과를 비교한 연구도 있고 무작위배정 연구도 진행이 되고 있지만 전이성 폐암에 대해서는 치료 방법에 따른 임상결과를 비교한 연구가 부족하여 본원에서 전이성 폐암을 대상으로 시행되었던 외과적 절제와 방사선수술의 임상결과를 후양적으로 비교한 연구입니다. 본 연구에서는 방사선수술이 외과적 절제와 비교할만한 치료 결과를 보여주어 여러 측면에서 적극적으로 고려해볼 수 있을 것으로 판단됩니다.
  • 덧글달기
    덧글달기
       IP : 54.224.90.25

    등록