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对肺瘤和严重肺功能损伤的患者进行立体性废除性放射治疗 (SABR)
Abraham André Arturo Geng-Cahuayme1, Blanca Peregrín-Pastor1, Mónica Ramos-Albiac1
1Department of Radiation Oncology, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain.
概括
立体除性放射疗法 (SABR) 在早期非小细胞肺癌 (NSCLC) 和重度慢性阻塞性肺病 (COPD) 患者的肺转移方面显示出有希望的结果. 这种治疗提供了有效的局部控制和生存,可控的毒性.
科学领域:
- 肺部医学 肺部医学
- 辐射瘤学 辐射瘤学
- 在瘤学瘤学.
背景情况:
- 患有严重慢性阻塞性肺病 (COPD) 和早期非小细胞肺癌 (NSCLC) 或肺转移的患者由于肺功能障碍,往往具有有限的治疗选择.
- 立体性除性放射治疗 (SABR) 是一种高度精确的辐射技术,在几次疗程中向瘤输送高剂量的辐射.
研究的目的:
- 为了评估SABR在COPD和严重肺功能障碍 (FEV1 ≤50%) 的患者队列中的临床结果和毒性,这些患者曾因早期NSCLC或肺转移而接受治疗.
- 评估SABR在这种高风险患者群体的整体存活率,癌症特异性存活率和局部控制方面的疗效.
主要方法:
- 进行了一项回顾性单中心研究,分析了2015年6月至2022年10月期间接受SABR治疗的患者的数据.
- 该研究包括患有严重COPD (FEV1 ≤50%) 和早期NSCLC或肺转移的患者.
- 评估了临床结果和毒性,随访时间中位数为2.9年.
主要成果:
- 分析了34名患者 (40个病变). 平均年龄为73.5岁,平均FEV1为38%.
- 平均整体生存时间为41.1个月. 两年,3年和5年的总生存率分别为79%,71%和36%.
- 两年,3年和5年的癌症特异性生存率分别为96%,96%,68%. 2,3年和5年的局部控制率分别为88%,83%和83%. 没有观察到4级或5级毒性;最常见的急性毒性是肺炎 (38.2%),只有2.9%的人经历了3级毒性.
结论:
- 对于患有早期NSCLC或肺转移,同时由于严重的COPD导致肺功能不佳的患者,SABR可以成为有效的治疗选择.
- 治疗表明可接受的毒性概况,严重不良事件的发病率低.
- 在这种具有挑战性的患者群体中,SABR提供了一种可行的治疗策略,以改善生存率和局部控制.
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