首页|射波刀治疗老年早期非小细胞肺癌的治疗效果与安全性

射波刀治疗老年早期非小细胞肺癌的治疗效果与安全性

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目的 探讨射波刀治疗老年(≥75 岁)早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的有效性与安全性,并与<75岁患者的结果对比.方法 回顾性分析2013年1月至2019年10月济南市解放军第960医院收治的75 例早期(T1-2N0M0)NSCLC患者.<75 岁患者 32 例(42.7%),≥75 岁患者 43 例(57.3%).所有患者剂量方案为 45~66Gy/3~8F,60%~85%等剂量线作为处方剂量包绕计划靶区(planning target volume,PTV),每日 1 次,每周 5 次.比较两组患者临床治疗效果、生存状况及治疗毒性,并分析影响≥75 岁患者生存期的因素.结果 <75 岁和≥75 岁患者疾病控制率分别为 96.9%和 93.0%(P>0.05).5 年局部控制率(local control,LC)、无进展生存率(progression-free survival,PFS)和癌症特异性生存率(cancer-specific survival,CSS)分别为 70.9%和 85.4%,58.5%和 54.4%,70.4%和 64.5%,差异均无统计学意义(P>0.05).但≥75 岁患者的生存率(overall survival,OS)明显低于<75 岁患者,5 年OS分别为 49.2%和68.2%(P<0.05).两组患者的治疗并发症比较,差异无统计学意义(P>0.05).多因素分析发现生物等效剂量(biologic effective dose,BED)是影响老年患者OS的独立因素.结论 采用射波刀对不适合手术的老年早期NSCLC患者行立体定向放射治疗是一种安全有效的治疗方式.
Efficacy and safety of cyberknife in the treatment of elderly patients with early stage non-small cell lung cancer
Objective To investigate the efficacy and safety of Cyberknife in the treatment of elderly patients(aged≥75 years)with early stage non-small cell lung cancer(NSCLC),and to compare the results with those of patients aged<75 years.Methods We retrospectively analyzed 75 patients with early(T1-2N0M0)NSCLC admitted to the 960th Hospital of Jinan People's Liberation Army from January 2013 to October 2019.There were 32(42.7%)patients aged<75 years,and 43(57.3%)patients aged≥75 years.All patients were treated with 45-66Gy/3-8F,60%-85%isodose line as the prescription dose to cover planning target volume(PTV),and irradiation once a day and five times a week.The clinical efficacy,survival status and radiotherapy toxicity of the two groups were compared,and the factors affecting the efficacy of elderly patients were analyzed.Results The disease control rates of patients aged<75 and≥75 years were 96.9%and 93.0%,respectively(P>0.05).The 5-year local control rate(LC),progression-free survival(PFS)and cancer-specific survival(CSS)were 70.9%and 85.4%,58.5%and 54.4%,and 70.4%and 64.5%,respectively(P>0.05).However,the overall survival(OS)of patients aged≥75 years was significantly lower than that of patients aged<75 years,and the 5-year OS was 49.2%and 68.2%,respectively(P<0.05).There was no significant difference in the treatment complications between the two groups(P>0.05).Multivariate analysis showed that biologic effective dose(BED)was an independent factor affecting OS in patients aged≥75 years.Conclusion Stereotactic body radiotherapy with cyberknife is a safe and effective treatment for elderly patients with early stage NSCLC who are not suitable for surgery.

Elderly patientsNon-small cell lung cancerEarly stage lung cancerStereotactic body radiotherapyCyberknife

李雪、汪延明、田芹、张弘旺

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锦州医科大学解放军第九六〇医院研究生培养基地,辽宁锦州 121012

解放军第九六〇医院放疗科,山东济南 250031

山东省立第三医院放疗科,山东济南 250031

老年患者 非小细胞肺癌 早期肺癌 立体定向放射治疗 射波刀

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(5)
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