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방사선종양학
- 2022년 01월호
[Radiat Oncol.] Treatment outcomes of re-irradiation using stereotactic ablative radiotherapy to lung: a propensity score matching analysis서울의대 / 이태훈, 김동윤, 김학재*
- 출처
- Radiat Oncol.
- 등재일
- 2021 Nov 18
- 저널이슈번호
- 16(1):222. doi: 10.1186/s13014-021-01948-6.
- 내용
Abstract
Background: The purpose of this study was to compare the treatment efficacy and safety of re-irradiation (re-RT) using stereotactic ablative radiotherapy (SABR) and initial SABR for primary, recurrent lung cancer or metastatic lung tumor.Methods: A retrospective review of the medical records of 336 patients who underwent lung SABR was performed. Re-RT was defined as the overlap of the 70% isodose line of second-course SABR with that of the initial radiotherapy, and 20 patients were classified as the re-RT group. The median dose of re-RT using SABR was 54 Gy (range 48-60 Gy), and the median fraction number was 4 (range 4-6). One-to-three case-matched analysis with propensity score matching was used, and 60 patients were included in the initial SABR group of the matched cohort.
Results: The 1- and 2-year local control rates for the re-RT group were 73.9% and 63.3% and those for the initial SABR group in the matched cohort were 92.9% and 87.7%, respectively (P = 0.013). There was no difference in distant metastasis-free, progression-free, and overall survival rates. The crude grade ≥ 2 toxicity rates were 40.0% for the re-RT group and 25.0% for the initial SABR group (P = 0.318). Re-RT group had higher acute grade ≥ 2 toxicity rates (25.0% vs 5.0%, P = 0.031). One incident of grade 3 toxicity (pulmonary) was reported in the re-RT group; there was no grade 4‒5 toxicity.
Conclusions: The local control rate of the in-field re-RT SABR was lower than that of the initial SABR without compromising the survival rates. The toxicity of re-RT using SABR was acceptable.
Affiliations
Tae Hoon Lee # 1 , Dong-Yun Kim # 1 , Hong-Gyun Wu 1 2 3 , Joo Ho Lee 1 , Hak Jae Kim 4 5 6
1 Department of Radiation Oncology, Seoul National University College of Medicine and Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
2 Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
3 Institute of Radiation Medicine, Medical Research Center, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
4 Department of Radiation Oncology, Seoul National University College of Medicine and Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. khjae@snu.ac.kr.
5 Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. khjae@snu.ac.kr.
6 Institute of Radiation Medicine, Medical Research Center, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. khjae@snu.ac.kr.
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- 키워드
- Lung cancer; Metastasis; Re-irradiation; Stereotactic radiation therapy.
- 연구소개
- 첫 치료시 처방선량의 70% 이상 겹치는 부위에서 재발한 환자들만을 대상으로 re_SABR 성적을 분석한 것으로 re_RT의 정의가 비교적 균일하고 propensity score matching시 re_RT의 LCR가 initial RT에 비해 낮지만 수술이 어려울 때 유효한 치료법이라 생각됩니다.
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편집위원
첫 치료시 처방선량의 70% 이상 겹치는 부위에서 재발한 환자들만을 대상으로 re_SABR 성적을 분석한 것으로 re_RT의 정의가 비교적 균일하고 propensity score matching시 re_RT의 LCR가 initial RT에 비해 낮지만 수술이 어려울 때 유효한 치료법이라 생각됩니다.
덧글달기닫기2022-01-04 17:36:33
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