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題名:螺旋刀放射治療儀低分次放射治療第四期非小細胞肺癌肺內病灶--單一中心經驗分享     (18點)
HYPOFRACTIONATE TOMOTHERAPY FOR INTRATHORACIC STAGE IV NON-SMALL CELL LUNG CANCER-A SINGLE INSTITUTION EXPERIENCE
著者:李政彥(Cheng-Yen Lee) ;張恆睿(Heng-Jui Chang) ;楊凱琳(Kai-Lin Yang) ;柯卉玲(Hui-Ling Ko) ;黃素禎(Su-Chen Huang) ;溫嘉綺(Chia-Chi Wen) ;季匡華(Kwan-Hwa Chi)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:肺癌 ; 螺旋刀放射治療儀 ; 低分次放射治療 ; Lung cancer ; Tomotherapy ; Hypofractionated radiotherapy
刊名:放射治療與腫瘤學
頁碼:97-105
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

目的:分析以螺旋刀放射治療儀低分次放射治療(HT, Hypofractionated Tomotherapy)第4期非小細胞肺癌(NSCLC, non-small cell lung cancer)肺內病灶之臨床經驗。
材料與方法:自2007年4月至2011年7月,共計有27位第4期NSCLC患者接受HT治療其肺內病灶。所有患者肺內病灶數目不大於5個,且任一病灶不大於5cm,主要分析為整體生存期、照野內復發以及放射性肺炎之發生。患者治療計畫需參考高能電腦斷層之影像(MVCT, megavoltage computerized tomography)。患者接受放射分次數介於9至16次,中位數為10次,單次劑量平均數為4.7±0.3Gy(平均數±標準差),總劑量平均數為48.6±6.8Gy。
結果:全部病人追蹤時間中位數(median follow up)為16.1月,追蹤期內無照野內復發。整體生存期中位數(median overall survival)為32.1月。患有肺外轉移病灶(EPD, extrapulmonary disease)之患者,其整體生存期中位數為11.2月,無EPD之患者,其整體生存期中位數則為38.6月,兩者之間具有顯著差異(p值等於0.003),以肺內病灶數量作觀察,轉移病灶數量小於3者,其整體生存期中位數為34.7月,轉移病灶數量介於3至5者,其整體生存期中位數則為32.1月,兩者之間無顯著差異(p值等於0.57)。肺內病灶總體積平均數為39.18±39.98cm3。肺平均劑量為7.34±3.38Gy。以肺內病灶總體積做評估,轉移病灶總體積小於或等於27.89cm3者,其整體生存期中位數為34.7月,轉移病灶總體積大於27.89cm3者,其整體生存期中位數則為12.3月,兩者之間具有具顯著差異(p值等於0.04)。共2位發生第3級以上之放射性肺炎。
結論:使用HT治療小於或等於5個第4期非小細胞肺癌肺內病灶,可得到良好之腫瘤局部控制率。有無肺外轉移病灶以及肺內病灶總體積皆為影響整體生存期之重要預後因子。
Introduction: To retrospectively evaluate Hypofractionated Tomotherapy (HT) on the treatment of intrathoracic lesions in patients with stage IV non-small cell lung cancer (NSCLC).
Material and Methods: Between April 2007 and July 2011, 27 stage IV NSCLC patients were treated with HT for their intrathoracic lesions. The number of intrathocic lesions was ≤5 and none of them exceeded 5 cm in greatest dimension. Overall survival, rate of in-field recurrence and incidence of radiation pneumonitis were analyzed. Megavoltage computerized tomography (MVCT) was utilized for tumor contouring. The mean radiation dose per fraction was 4.7±0.3 Gy (mean ± standard deviation) and the number of fractions ranged between 9 and 16 (median: 10 fractions). Total irradiation dose was 48.8±6.8 Gy.
Results: The median follow-up period was 16.1 months. There was no in-field failure. The median duration of overall survival was 11.2 months among patients with extrapulmonary disease (EPD) and 38.6 months among patients without EPD (p=0.03). The median duration of overall survival was 34.7 months among patients with <3 intrathoracic GTVs and 32.1 months among patients with 3-5 intrathoracic GTVs (p=0.57). The aggregated intrathoracic GTV in each patient averaged 39.18±39.98 cm3. The median duration of overall survival was 38.6 months among patients with aggregated intrathoracic GTV ≤27.89 cm3 and 12.3 months among patients with aggregated intrathothoracic GTV >27.89 cm3 (p=0.04). Two patients developed grade 3 or greater radiation pneumonitis.
Conclusion: HT may be feasible for selected stage IV NSCLC patients with the number of intrathoracic lesions less than or equal to 5. Excellent local control can be anticipated. Presence of EPD and volume of intrathoracic lesions may be significant prognostic factors for overall survival.


    

本卷期目次
放射治療與腫瘤學
THE IMPACT OF PRONE POSITION WITH BELLY-BOARD DEVICE ON THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY OF PROSTATE CANCER: DECREASING THE RECTUM COMPLICATION PROBABILITY/ Yu-Ming LiuLiang-Hsiao ChaoChun-Wei WangSang-Hue YenMei-Ling LeeChuen-Mei HsiehYuh-Lin LeePin-I HuangLing-Wei WangCheng-Ying Shiau
評估頭頸部模型使用的TIMO枕與壓克力枕在放射治療中的再現性與舒適度/ 高菁苓林信吟劉煥彰林倩伃范綱行劉義誠陳柏元
癌症多專科團隊會議運作模式與未來展望許維中/ 廖宏恩鍾娜娜王博民詹淑卿
研究overshoot effect對於執行強度調控放射治療之影響及劑量修正/ 王思文游浚彥周文采朱俊男賴姿云翁益強楊世能梁基安
TOMOTHERAPY FOR CERVICAL CANCER WITH BILATERAL TOTAL HIP REPLACEMENT/ Hsin-Hua LeeShi-Long LianChih-Jen Huang
利用放射線治療默克細胞癌淋巴腺轉移的病患--病例報告/ 葉啓源劉芳慧賴鵬安
PROGNOSTIC FACTORS AFTER ADJUVANT RADIOTHERAPY IN CERVICAL CANCERS: A RETROSPECTIVE STUDY/ Po-Chun ChenWen-Shan LiuChien-Hsun ChenChing-Hsiung ChangPei-Ling TangChung-Man LeungYu-Chang HuKuo-Chen Chang
螺旋刀放射治療儀低分次放射治療第四期非小細胞肺癌肺內病灶--單一中心經驗分享/ 李政彥張恆睿楊凱琳柯卉玲黃素禎溫嘉綺季匡華
 
   
 
   

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