目的:评估早期非小细胞肺癌(NSCLC)或肺转移的慢性阻塞性肺疾病(COPD)患者的SABR治疗后的临床结局。
方法:回顾性单中心研究分析2015年6月1日至2022年10月31日接受SABR治疗的COPD严重肺功能障碍患者的临床结果和毒性反应。
结果:纳入34例患者(40个地点)进行分析。中位随访时间为2.9年。中位年龄为73.5岁(范围,65.6-80.1)。FEV1为38%(范围,28.2-50.0)放疗前。中位总生存期(OS)为41.1个月(95%CI38.9-未达到)。操作系统速率为2-,3-,五年是79%,71%,36%,分别。癌症特异性生存率为2-,3-,五年是96%,96%,68%,分别。本地控制率为2-,3-,五年是88%,83%,83%,分别。没有观察到4级或5级毒性。最常见的急性毒性是肺炎(38.2%),其中只有1例患者(2.9%)报告了3级急性毒性。
结论:肺功能不良患者的肺SABR可能是有效的,且毒性可接受。
OBJECTIVE: To evaluate clinical outcomes after SABR in a cohort of early-stage non-small cell lung cancer (NSCLC) or pulmonary metastases in chronic obstructive pulmonary disease (COPD) patients with forced expiratory volume in the first second predicted (FEV1) ≤ 50%.
METHODS: Retrospective single-center study was performed to analyze clinical outcomes and toxicities in COPD patients with severe lung dysfunction treated with SABR from 1st June 2015 to 31st October 2022.
RESULTS: Thirty four patients (forty locations) were enrolled for analysis. Median follow-up was 2.9 years. Median age was 73.5 years (range, 65.6-80.1). FEV1 was 38% (range, 28.2-50.0) prior to radiotherapy. Median overall survival (OS) was 41.1 months (95% CI 38.9-not reached). OS rates at 2-, 3-, and 5- years were 79%, 71%, and 36%, respectively. Cancer-specific survival rates at 2-, 3-, and 5- years were 96%, 96%, and 68%, respectively. Local control rates at 2-, 3-, and 5- years were 88%, 83%, and 83%, respectively. No grade 4 or 5 toxicity was observed. The most common acute toxicity was pneumonitis (38.2%), of which only 1 patient (2.9%) reported grade 3 acute toxicity.
CONCLUSIONS: Lung SABR in patients with poor pulmonary function may be effective with acceptable toxicity.