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体部伽玛刀治疗i、ii期非小细胞肺癌的近期疗效观察空军总医院放疗科
Promising clinical outcome of stereotactic body radiosurgery in the treatment of patients with medically inoperable stage I/II non-small cell lung cancer? Tingyi Xia,1 Qingxuan Sun,1 Hongqi Li, 1Yingjie Wang, 1 and Joe Y. Chang2 1 Department of Radiation Oncology, Air Force General Hospital, Beijing, China; 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA Material and Methods: 43 patients of stage I (n=25) and II (n=18) NSCLC KPS 70 Local control was evaluated based on the CT images at 3, 6, 12 months after treatment and then as clinically indicated Kaplan-Meier was used to calculate survival rate and local control rate. Treatment design: CT-Sim PTV: GTV + 1 cm Single focus or multi-focus radiation was used according to different sizes of target Dose prescribed to 50% dose line 50% dose line covers PTV and 75% dose line covers more than 95% of GTV. Radiation dose: 50 GY with 5 GY/ fraction For N1 case of lymph node in lung hilum, same or slightly less dose was delivered to LN 30 cobalt-60 sources scattered in the cavity of the primary collimator. The source body rotates horizontally around the central axis and 30 bundles of gamma radials were focalized onto focus point. Three sizes of collimators with dose focus of 1 cm, 3 cm and 5 cm. Smaller focus achieves sharper dose gradient. Combination of three collimators, 1-10cm tumors can be treated. Results (1) Relation between clinical response and size of tumor Tumor n CR PR SD <3cm 25 68.0%(17/25) 32.0%(8/25) 0 >3cm 18 55.6% (10/18) 33.3%(6/18) 11.1%(2/18) P 0.05 (2) Relation between stage and LC and OS LC(%) OS(%) 1Y 2Y 3Y 1Y 2Y 3Y I 25 100 96.0 96.0 100 90.9 90.9 II 18 88.9 83.3 83
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