射波刀治疗31例晚期非小细胞肺癌患者的疗效观察

BACKGROUND AND OBJECTIVE: Recently, Cyberknife is a new flame-less stereotactic radiation therapy technology, which has several advantages, such as large dose, high precision and minimizing exposure to the surrounding normal tissue or adjacent vital structures, so it is successful in the treatment of non-small cell lung cancer (NSCLC). The aim of this study is to determine the effectiveness and safety of robotic stereotactic radiotherapy-Cyberknife with image guidance and realtime respiratory tracking against clinical stage Ⅲ-Ⅳ peripheral NSCLC. METHODS: A review of treatment details and outcomes for 31 patients, with 34 tumors with histologically proven cancers treated by Cyberknife at the CyberKnife Center of Nanjing general hospital of Nanjing military command between March 2009 and March 2010 is presented. Of the 31patients, 15 were adenocarcinoma and 12 were squamous cell cancer. Twenty-eight patients received other forms of antineoplastic therapy such as chemotherapy. A total dose of 36 Gy-60 Gy was prescribed to the 65%-85% isodose line and given in two to fve fractions in less than 1 week using the CyberKnife radiosurgery system. CT scans were performed afer one-two months, then patients were followed every 3 months. RESULTS: Two patients had complete radiographic responses, 16 patients showed PRs, 7 patients showed SDs. Two patients showed PRs (reduction in tumor size), but developed distant metastases. Response rate was 58% and disease control rate was 81%. All patients tolerated the radiosurgery well, fatigue being the main side effect. No grade 4 or above toxicity was encountered. CONCLUSION: In this small cohort of patients with advanced peripheral NSCLC, Cyberknife seems to be a safe and has good therapeutic effects with slight adverse reaction, but long time follow-up is necessary to evaluate the survival data and late toxicity.