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目的:评价射波刀治疗Ⅰ期周围型非小细胞肺癌的临床疗效和安全性。方法:50例Ⅰ期周围型非小细胞肺癌患者(84%的患者有病理学诊断)接受射波刀治疗,其中ⅠA期30例,ⅠB期20例;放疗总剂量为48～60Gy(中位剂量为57Gy),72%以上的等剂量面必须包括95%以上的计划靶体积。50例患者均采用肿瘤内植入金标的同步呼吸追踪技术,完成治疗后评估近期和远期疗效以及不良反应。结果:随访时间为3～40个月(中位随访时间为29个月),其中完全缓解40例、部分缓解6例、疾病稳定2例、疾病进展2例,有效率为92%,2年局部控制率为96%;1年总生存率为86%,2年总生存率为74%。3例患者发生Ⅲ级穿刺相关并发症,5例发生Ⅲ级治疗相关不良反应。结论:对于无法手术的Ⅰ期周围型非小细胞肺癌患者,射波刀治疗是一种近期及远期疗效均较好的治疗方法,且不良反应可以耐受,但对其长期的疗效和不良反应仍有待进一步观察。
Objective: To evaluate the clinical efficacy and safety of laser knife treatment of stage I non-small cell lung cancer. Methods: Fifty patients with stage I NSCLC (84% of patients had pathological diagnosis) were treated with laser knife. Among them, 30 patients were in IA stage and 20 cases in stage IB. The total dose of radiotherapy was 48～60Gy (median). The dose is 57 Gy) and more than 72% of the isodose surface must include more than 95% of the planned target volume. All 50 patients were treated with synchronized breath tracking technology implanted with gold in the tumor. Short-term and long-term efficacy and adverse reactions were evaluated after completion of treatment. Results: The follow-up time was 3 to 40 months (median follow-up time was 29 months), including complete remission in 40 cases, partial remission in 6 cases, stable disease in 2 cases, and disease progression in 2 cases. The effective rate was 92% for 2 years. The local control rate was 96%; the one-year overall survival rate was 86%, and the 2-year overall survival rate was 74%. Grade III puncture-related complications occurred in 3 patients and grade III treatment-related adverse reactions occurred in 5 patients. Conclusion: For patients with stage I peripheral non-small cell lung cancer who cannot be operated, Knife knives are a good treatment for short-term and long-term outcomes, and the adverse reactions can be tolerated, but their long-term efficacy and poor The reaction remains to be further observed.