AAAs联合SBRT治疗超中心肺肿瘤的毒

治白癫疯办法 http://m.39.net/pf/bdfyy/bdfal/

SCI

14April

AnalysisofToxicEffectsWithAntiangiogenicAgentsPlusStereotacticBodyRadiationinUltracentralLungTumors

WangC,RimnerA,GelblumDY,etal.AnalysisofToxicEffectsWithAntiangiogenicAgentsPlusStereotacticBodyRadiationinUltracentralLungTumors.JAMAOncol.

CorrespondingAuthor:AbrahamJ.Wu,MD,DepartmentofRadiationOncology,MemorialSloanKetteringCancerCenter,YorkAve,NewYork,NY(wua

mskcc.org).

SUMMARY摘要

Lungstereotacticbodyradiationtherapy(SBRT)isaneffectiveandgenerallysafetreatmentforlungcancer,butahigherrateoftoxiceffectshasbeenreportedforSBRTwithinthecentrallungzone.PatientsreceivingSBRTfortumorsabuttingtheproximalbronchialtree(PBT)oresophagus,knownas“ultracentral”tumors,mayhaveaparticularlyhighriskoftoxiceffects.Antiangiogenicagents(AAAs)havebeensuspectedtopotentiateSBRTtoxiceffectsinotherbodysites.Herein,wereportonthetoxiceffectsassociatedwithSBRTforultracentrallungtumors,withafocusonexposuretoAAAs.

肺部立体定向放疗(SBRT)是治疗肺癌的一种有效且普遍安全的治疗方法，但据报道，SBRT在肺中心区域的毒性反应率相对较高。毗邻近端支气管(PBT)或食道的肿瘤（被称为“超中心”肿瘤）患者行SBRT治疗可能具有特别高的毒性作用风险。抗血管生成药物(AAAs)已被怀疑在其他身体部位增强SBRT的毒性作用。在此，我们报告了在AAAs的暴露下，超中心肺肿瘤的SBRT相关毒性作用。

DISCUSSION讨论

Localcontrolofultracentrallungtumorsisimportantbecauseprogressionmaycauseairwayobstructionorbleeding.However,thislocationischallengingtoaddresswithsurgeryorradiofrequencyablationowingtoitsproximitytocentralairwaysandmediastinalstructures.ThefeasibilityandsafetyofnoninvasivelocaltherapysuchasSBRTisthereforeofparticularinterest.

对超中心肺肿瘤的局部控制很重要，因为其进展可能导致气道阻塞或出血。然而，由于此位置靠近中央气道和纵隔，手术及射频消融术很难处理。因此，SBRT等非侵入性局部治疗的可行性和安全性受到重视。

Toourknowledge,thisisthelargestreportedseriesofSBRTforultracentrallungtumors.Theobservedincidenceofgrade3orhighertoxiceffects(n=19of88patients,22%)andfataltoxicevents(n=10of88patients,11%)isconsiderable,indicatingthatpatientswithultracentrallungtumorstreatedwithSBRTandanAAAareathighriskofgrade3orhighertoxiceffects.

据我们所知，这是目前报道的SBRT治疗超中心肺肿瘤的最大系列报道。观察到的3级或更高毒性反应(88例中有19例,22%)和致命的毒性事件88例中有10例,11%)的发生率相当大,表明超中心肺肿瘤患者接受SBRT和AAA的3级风险很高且毒性作用更强。

However,somestudiesofSBRThavereportednoexcessriskassociatedwithSBRTforultracentraltumors

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