SBRT治疗早期非小细胞肺癌的研究进展

肺癌仍处于恶性肿瘤发病率和死亡率的首位,非小细胞肺癌(NSCLC)是肺癌的主体,NSCLC患者中有15%~25%可以被早期发现(ⅠA或ⅠB期),而且随着影像诊断技术的发展,这个比例在不断升高。目前针对能够耐受手术的早期NSCLC患者的标准治疗仍然是手术。但是,早期NSCLC患者中只有约60%可以耐受根治性手术。对于不能耐受手术的早期NSCLC患者,以往,认为传统放疗(1.8~2.0 Gy/次,1次/天,6~7周)是其标准治疗方法,但是疗效欠佳;有研究证明传统放疗效果不佳是由于局部剂量不足。目前,几项长期随访研究都证明体部立体定向放射治疗(SBRT)对不能手术的Ⅰ/Ⅱ期NSCLC患者有效并且安全,SBRT已经成为不能手术的早期NSCLC患者的标准治疗方法。对于能够手术的病人,SBRT也逐步成为一种可以替代手术的治疗方法。

Stereotactic Body Radiotherapy(SBRT)for Early-Stage Non-small Cell Lung Cancer

Lung cancer remains one of the most frequent causes of cancer death in worldwide. Most of patients with bronchogenic carcinoma will be diagnosed with Non - small Cell Lung Cancer （ NSCLC ）. With the popularization of computed tomography （CT） screening, NSCLC are increasingly detected at an early stage （IA or IB）. Surgical resection remains the standard treatment for patients with stage I NSCLC. But only 60% of them is operable. The conventional radiotherapy administering a total dose of 60 - 66 Gy in 1.8 to 2.0 Gy/fraction for early - stage NSCLC is considered reasonable nonsurgical therapy for patients who can not tolerate surgery, with poor local control rates and survival rates. The poor results with conventional radiotherapy have been attributed to doses that are too low to control the tumor. Many long - term follow - up research demonstrate that SBRT has become the standard treatment for patients with early - stage NSCLC who cannot be resected, even for those who can tolerate surgery.