J. Thorac. Oncol.：立体定向消融放疗有望根除非小细胞肺癌

直到前不久，许多患有I期非小细胞肺癌(stage I non-small cell lung cancer)的老年患者都未接受过治疗，这是因为治疗可能并不改善他们的生活质量。然而，立体定向消融放疗(stereotactic ablative radiotherapy, SABR)已成为治疗这些病人的标准方法之一。给予为期两周的门诊治疗允许体弱的病人接受这种放疗。

研究人员想知道这种治疗在维持病人健康相关的生活质量方面是否与外科手术治疗的情形相同。研究人员对在荷兰68个中心接受SABR治疗的382名病人进行调查问卷。这项调查问卷要求病人对身体功能、食欲不振、疼痛和情绪功能等方面进行评分。

根据发表在国际肺癌研究协会杂志《胸腔肿瘤期刊》(Journal of Thoracic Oncology) 2012年7月那期上的一项研究，研究人员作出结论：就这些病人而言，与健康相关的生活质量似乎并没受到这种治疗的负面影响。

研究人员的结论是，与接受外科手术治疗的那些病人相比，在接受SABR头两年治疗后，包括功能性和症状结果在内的生活质量指标测试分数并没有发生恶化。

doi:10.1097/JTO.0b013e318219aac5
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Radiological Changes After Stereotactic Radiotherapy for Stage I Lung Cancer

Dahele, Max MBChB, MSc; Palma, David MD; Lagerwaard, Frank MD, PhD; Slotman, Ben MD, PhD; Senan, Suresh FRCR, PhD

Introduction: Stereotactic body radiation therapy (SBRT) is entering routine clinical use for selected patients with early-stage non-small cell lung cancer. Post-SBRT radiological changes are commonly seen on follow-up computed tomography (CT) imaging and can cause diagnostic dilemmas. The aim of this study is to describe the incidence, radiological severity, and long-term morphology of these changes. Methods: CT scans from patients treated between 2003 and June 2008 were eligible for evaluation if radiological follow-up had been performed at our center for at least 2 years, and there was no definite evidence of local recurrence. Timing, incidence, morphology, and severity of lung changes were determined. Results: CT scans from 61 patients (68 lesions) with a median follow-up of 2.5 years were evaluated. Within 6 months, 54% of lesions were associated with additional radiological abnormalities, and this figure reached 99% after 36 months. Most changes were scored as mild to moderate, and although the median time to first observation was 17 weeks, 25% appeared ≥1 year post-SBRT. In 47% of lesions, the morphology or severity of changes continued to evolve more than 2 years posttreatment. Conclusions: Mild-moderate radiological changes are common after lung SBRT. Some degree of late change is nearly universal, and it often continues to evolve more than 2 years post-SBRT. Clinicians should be aware of these radiological findings, which need to be distinguished from the uncommon cases of local failure post-SBRT.