高危肺癌队列的大分割和立体定向体部质子放疗：质子协作组前瞻性登记处的多中心经验
Hypofractionated and stereotactic body proton radiotherapy for a high-risk lung cancer cohort: A multi-institutional experience from the proton collaborative group prospective registry.
摘要(中文译文)
肺癌通常采用立体定向体部放疗（SBRT）和大分割放疗（HFRT）治疗。采用质子束治疗（PBT）实施这些消融性方案可能在剂量学和临床上带来优势，尤其对于高危病例。我们评估了SBRT/HFRT质子束治疗肺部肿瘤的安全性和有效性，包括不利亚组。从一项前瞻性多机构注册研究中筛选出接受≤15次质子束治疗的成人肺部肿瘤患者。符合条件的方案包括4-5次、每次≥10Gy（总剂量≥48Gy）或8-15次、每次≥3.5Gy（总剂量≥52.5Gy）。局部控制（LC）采用以死亡为竞争风险的累积发生率进行估计，亚组比较采用Fine-Gray模型。共纳入104例患者、110个肿瘤（83.6%为非小细胞肺癌）：32.7%肿瘤≥4cm，41.8%为超中央型，30%为再程放疗。最常见的方案为60Gy/15次（40%）和50Gy/5次（17.2%）；71.8%接受了调强质子束治疗。1年和2年局部控制率分别为83.1%和77.4%，在不同肿瘤大小、超中央位置或再程放疗之间无差异。接受95%处方剂量的内大体肿瘤体积与局部控制改善相关（=0.007）。最常见的毒性反应为咳嗽（40%）和呼吸困难（34.5%），无≥3级不良事件。在针对高危肺部肿瘤队列采用调强质子束治疗实施SBRT/HFRT的最大前瞻性入组报告中，1年和2年局部控制率分别为83.1%和77.4%，无≥3级毒性反应。局部控制在高危亚组之间相似。然而，较短的生存期和随访时间限制了对研究结果的评估。尽管有前瞻性注册研究，许多患者可靠的长期随访数据仍然有限，在一定程度上限制了结果的解读。
Abstract
Lung cancer is commonly treated with stereotactic body radiotherapy (SBRT) and hypofractionated RT (HFRT). Delivering these ablative regimens with proton beam therapy (PBT) may yield dosimetric and clinical advantages, particularly for high-risk cases. We evaluated safety and efficacy of SBRT/HFRT PBT for lung tumors, including unfavorable subgroups. Adults with lung tumors treated with PBT ≤15 fractions were identified from a prospective, multi-institutional registry. Eligible regimens included 4-5 fractions at ≥10Gy/fraction (≥48Gy total) or 8-15 fractions at ≥3.5Gy/fraction (≥52.5Gy total). Local control (LC) was estimated using cumulative incidence with death as a competing risk, and Fine-Gray models were used for subgroup comparisons. 104 patients with 110 tumors (83.6% non-small cell lung cancer) were included: 32.7% ≥4 cm, 41.8% ultracentral, and 30% re-irradiated. Most common regimens were 60Gy/15 fractions (40%) and 50Gy/5 fractions (17.2%); 71.8% received intensity-modulated PBT. 1-and 2-year LC rates were 83.1% and 77.4%, with no difference by tumor size, ultracentral location, or re-irradiation. Internal gross tumor volume receiving 95% of dose was associated with improved LC ( = 0.007). Most common toxicities were cough (40%) and dyspnea (34.5%), with no Grade ≥ 3 events. In the largest prospectively enrolled report of SBRT/HFRT via intensity-modulated PBT for a high-risk lung tumor cohort, 1- and 2-year LC rates were 83.1% and 77.4%, with no grade ≥ 3 toxicities. LC was similar among high-risk subgroups. However, short survival and follow-up durations limited assessment of the findings. Despite the prospective registry, reliable long-term follow-up data remained limited for many patients, somewhat restricting result interpretation.
如何引用
AMA
Alexander J Allen, Charles B Simone, Kai Sun, David F Alicia, Ajay Banskota, Gopal K Bajaj, et al. Hypofractionated and stereotactic body proton radiotherapy for a high-risk lung cancer cohort: A multi-institutional experience from the proton collaborative group prospective registry.. Clinical and translational radiation oncology. 2027; doi:10.1016/j.ctro.2026.101291.
APA
Alexander J Allen, Charles B Simone, Kai Sun, David F Alicia, Ajay Banskota, Gopal K Bajaj, et al (2027). Hypofractionated and stereotactic body proton radiotherapy for a high-risk lung cancer cohort: A multi-institutional experience from the proton collaborative group prospective registry.. Clinical and translational radiation oncology. https://doi.org/10.1016/j.ctro.2026.101291
GB/T 7714
Alexander J Allen, Charles B Simone, Kai Sun, David F Alicia, Ajay Banskota, Gopal K Bajaj, et al. Hypofractionated and stereotactic body proton radiotherapy for a high-risk lung cancer cohort: A multi-institutional experience from the proton collaborative group prospective registry.[J]. Clinical and translational radiation oncology, 2027 doi:10.1016/j.ctro.2026.101291.
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