Keywords
How to Cite
Abstract
Material and methods: Since 2014, 33 patients with lung cancer of clinical stage I-IIa (cT1N0M0 - 12 patients, with T2N0M0 - 21 patients) have undergone SRT. Verification of tumor process was obtained in 30 patients. A third of patients (n = 10) had a history of metachronic primary-multiple tumors and 31 patients had peripheral lung cancer. The used variants of SRT fractionation were as followed: 10Gr x 5 fractions (n = 22) and 7Gr x 8 fractions (n = 11) - BED 100Gy.
Results: With a median follow-up of 21 months (range 3-37 months), 4 patients (12 %) within the first year had a loco-regional and distant progression, of which two died. During the year one patient died from complications of treatment, one - from the progression of the second tumor. One- and two-year local control was 94 %. Overall and disease-free 2-year survival was 84 % (95 % CI, 70 - 99) and 83.2 % (95 % CI, 70.5 - 99), respectively. Single-factor analysis revealed a significant effect on the overall survival of the fractionation regimen (p = 0.04). The effect of the baseline SUVmax tended to be reliable (p = 0.07).
Conclusions: In order to implement the principles of risk-adaptive radiation therapy it is necessary to consider the initial SUVmax of tumor as one of potential predictive and predicative markers of treatment effectiveness.
References
Аксель Е.Г., Давыдов Г.И. Статистика злокачественных новообразования в России и странах СНГ в 2012 г. - Госква, 2014. - 226 с.
Давыдов Г.И. Современные принципы выбора лечебной тактики, и возможность хирургического лечения немелкоклеточного рака легкого / Г.И. Давыдов, Б.Е. Полоцкий // Сб. «Новое в терапии рака легкого» / под ред. Н.И. Переводчиковой. Г., 2003. - С. 41-53.
Chang J.Y, Senan S., Paul M.A. et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials // Lancet Oncol. - 2015. - Vol. 16. - № 6. - P. 630-637.
Dalwadi S.M., Szeja S., Teh B.S. et al. Outcomes in elderly stage I non-small cell lung cancer in the stereotactic body radiation therapy era: a surveillance, epidemiology, and end results analysis // International Journal of Radiation Oncology. - 2016. - Vol. 96. - № 2. - P. 68.
Howlader N., Noone A.M., Krapcho M. et al. SEER Cancer Statistics Review, 1975-2012, National Cancer Institute.
Konert T., Vogel W., MacManus M.P et al. PET/CT imaging for target volume delineation in curative intent radiotherapy of non-small cell lung cancer: IAEA consensus report 2014 // Radiother Oncol. - 2015. - Vol. 116. - P. 27-34.
Li L, Ren S., Zhang Y, Guan Y et al. Risk factors for predicting the occult nodal metastasis in T1-2N0M0 NSCLC patients staged by PET/CT: potential value in the clinic // Lung Cancer. - 2013. - Vol. 81. - № 2. - P 213-217.
Meng X., Sun X., Mu D. et al. Noninvasive evaluation of microscopic tumor extensions using standardized uptake value and metabolic tumor volume in non-small-cell lung cancer // Int. J. Radiat. Oncol. Biol. Phys. - 2012. - Vol. 82. - № 2. - P. 960-966.
Palma D., Visser O., Lagerwaard F.J. et al. Impact of Introducing Stereotactic Lung Radiotherapy for Elderly Patients With Stage I Non-Small-Cell Lung Cancer: A рopulation-Based Time-Trend Analysis // J. Clin. Oncol. - 2010. - Vol. 28. - № 35. - P 5153-5159.
Pezzi C.M., Mallin K., Mendez A.S. et al. Ninety-day mortality after resection for lung cancer is nearly double 30-day mortality // J. Thorac. Cardiovasc. Surg. - 2014. - Vol. 148. - № 5. - P. 2269-2277.
Rami-Porta R., Ball D., Crowley J. et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer // J. Thorac. Oncol. -2007. - № 2. - P. 593-602
Schmidt-Hansen M., Baldwin D.R., Hasler E. et al. PET-CT for assessing mediastinal lymph node involvement in patients with suspected resectable non-small cell lung cancer //Cochrane Database Syst Rev. - 2014. - Vol. 13. - № 11. - CD009519. - CD009519.pub2 DOI: 10.1002/14651858
Shirvani S.M., Jiang J., Chang J.Y et al. Lobectomy, sub-lobar resection, and stereotactic ablative radiotherapy for early-stage non-small cell lung cancers in the elderly // JAMA Surg. - 2014. - Vol. 149. - № 12. - P. 1244-1253
Torre L.A., Bray F., Siegel R.L. et al. Global cancer statistics, 2012 // CA Cancer J. Clin. - 2015. - № 5. - P 87-108
Van den Berg L.L., Klinkenberg T.J., Groen H.J., Widder J. Patterns of Recurrence and Survival after Surgery or Stereotactic Radiotherapy for Early Stage NSCLC // J. Thorac. Oncol. - 2015. - Vol. 10. - № 5. - P 826-831
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2017