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PPT课件PromisingclinicaloutcomeofstereotacticbodyradiosurgeryinthetreatmentofpatientswithmedicallyinoperablestageI/IInon-smallcelllungcancer TingyiXia,1QingxuanSun,1HongqiLi,1YingjieWang,1andJoeY.Chang21DepartmentofRadiationOncology,AirForceGeneralHospital,Beijing,Ch...
PromisingclinicaloutcomeofstereotacticbodyradiosurgeryinthetreatmentofpatientswithmedicallyinoperablestageI/IInon-smallcelllungcancer TingyiXia,1QingxuanSun,1HongqiLi,1YingjieWang,1andJoeY.Chang21DepartmentofRadiationOncology,AirForceGeneralHospital,Beijing,China;2DepartmentofRadiationOncology,TheUniversityofTexasMDAndersonCancerCenter,Houston,Texas77030,USAMaterialandMethods:43patientsofstageI(n=25)andII(n=18)NSCLCKPS>70LocalcontrolwasevaluatedbasedontheCTimagesat3,6,12monthsaftertreatmentandthenasclinicallyindicatedKaplan-Meierwasusedtocalculatesurvivalrateandlocalcontrolrate.Treatmentdesign:CT-SimPTV:GTV+1cmSinglefocusormulti-focusradiationwasusedaccordingtodifferentsizesoftargetDoseprescribedto50%doseline50%doselinecoversPTVand75%doselinecoversmorethan95%ofGTV.Radiationdose:50GYwith5GY/fractionForN1caseoflymphnodeinlunghilum,sameorslightlylessdosewasdeliveredtoLNBodyGammaKnife:30cobalt-60sourcesscatteredinthecavityoftheprimarycollimator.Thesourcebodyrotateshorizontallyaroundthecentralaxisand30bundlesofgammaradialswerefocalizedontofocuspoint.Threesizesofcollimatorswithdosefocusof1cm,3cmand5cm.Smallerfocusachievessharperdosegradient.Combinationofthreecollimators,1-10cmtumorscanbetreated.1cm3cm5cmResults(1)RelationbetweenclinicalresponseandsizeoftumorTumornCRPRSD＜3cm2568.0%（17/25)32.0%(8/25) 0＞3cm1855.6%（10/18)33.3%(6/18)11.1%（2/18)P>0.05(2)RelationbetweenstageandLCandOS LC（%） OS（%） 1Y 2Y 3Y 1Y 2Y 3YI 25 10096.096.0100 90.990.9II 18 88.983.383.372.763.663.6I/II4395.390.090.077.677.877.8Stage n Month403632282420161286420Localcontrol1.11.0.9.8.7.6.5.4StageII（83.3%）StageI（95.8%）(3)LCinstageI-IINSCLCStageI－II（90.0%）Month403632282420161286420Survival1.11.0.9.8.7.6.5.4StageII（63.5%）StageI（90.9%）(4)OSinstageI-IINSCLC（P＝0.0474）StageI－II（77.8%）(5) Sideeffects(RTOG/EORTC) Grade 0 I II III IVPneumonitis 3562 00Esophagitis 365200 Hematological334200 Case180y/oleftlungsquamouscelllungcancer(T1N0M0)3monthsafterRTBeforeRTBeforeRT3monthsafterRT85y/o，RULadenocarcinoma(T1N1M0)Case26monthsafterRT15monthsafterRTBeforeRT3monthsafterRT71y/oRLLNSCLC，(T2N0M0)Case3
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