Erken Evre Küçük Hücreli Dışı Akciğer Kanserlerinin Tedavisinde Robotik Radyocerrahi

Abstract

Amaç: Bu çalışmada Anadolu Sağlık Merkezi’nde robotik SBRT uygulanan erken evre akciğer kanserli olguların tedavi sonuçları geriye dönük olarak incelenip lokal kontrol ve sağkalım süreleri istatiksel olarak raporlanmaya çalışıldı. Yöntem: Kliniğimizde 2005-2016 tarihleri arasında SBRT uygulanan opere edilemeyen ya da cerrahi istemeyen, T1-T2N0M0 evre 135 olgunun incelendi. 87 olgu Synchrony Takip yöntemi ile, 34 olgu X Sight Lung yöntemi ile tedavi edilirken 17 olgu X Sight Spine Takip yöntemi ile tedavi edildi. Medyan fraksiyon sayısı 3 (1-8) idi. Medyan BED10 değeri ise 180 Gy (45-180’ di. Tedaviye yanıt BT ve/veya PET/BT ile değerlendirildi. Medyan yaş değeri 65 (44-88) olan olguların 108’i erkek iken 27’si kadındı. Medyan takip süresi 19 (3-88), medyan sağkalım ise 34 ay hesaplandı. Bulgular: Çalışmaya dahil edilen olgulara ait 1, 2, 3 ve 5 yıllık sağkalım %88, %72, %50 ve %39 iken aynı süreler için lokal kontrol ise %81, %54, %51 ve % 39 olarak elde edildi. BED=180 Gy ve BED<180 Gy olarak tedavi dozunun etkisi araştırıldığında dozun sağkalıma ve lokal kontrole etkisi anlamlı bulundu (p=0,002, p=0,008). Sonuç: Gerçek zamanlı tümör hareket takibi ile Cyberknife stereotaktik radyocerrahi tedavisi, ameliyat edilemeyen erken evre akciğer olgularında umut verici ve tolere edilebilen bir tedavi seçeneğidir.

Keywords

• SBRT
• akciğer kanseri
• CyberKnife

Robotic Stereotactic Body Treatment for Early Stage non-Small Cell Lung Cancer

Abstract

Objective: In this study, we retrospectively reviewed and statistically analyzed the Cyberknife SBRT outcomes in terms of local control and survival times for the patients with primer lung tumors treated at Anadolu Medical Center. Methods: We included 135 patients who were treated between 2005 and 2016 and diagnosed primary lung cancer who were judged medically inoperable. median BED10 was 180 Gy (ranging 45-180). The treatment response was assessed using either a CT or a PET-CT scan or both. There were 108 men and 27 women, with an overall median age of 65 years (range 44-88 years). The median follow-up and overall survival were 19 (3-88) and 34 months, respectively. Results: Overall survival and local control of the patients for 1, 2, 3, 5 years were 88%, 72%, 50%, 39%, and 81%, 54%, 51%, 39%, respectively. 1, 2 and 3 year survival rates for BED10=180Gy group were 89%, 84% and 72% respectively. 1, 2 and 3 year survival rates were found as 88%, 68% and 42% for BED<180Gy, respectively. 1, 2 and 3 year local control rates for BED=180Gy group were found as 92%, 86% and 86% respectively. 1, 2 and 3 year local control rates for BED<180Gy group were found as 78%, 42% and 38%. Local control and overall survival were associated with higher BED10. The difference between survival and local control of BED=180 Gy and BED<180 Gy are significant (p=0.008, p=0.002). Conclusion: The Cyberknife stereotactic radiosurgery treatment with real-time tumor motion tracking is a promising well tolerated treatment option for inoperable early stage lung tumors.

Keywords

• SBRT
• lung tumors
• CyberKnife

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