高级检索
中华肿瘤杂志
期刊首页
过刊列表
高级检索
稿件发表
• 指南与规范 •
ENGLISH ABSTRACT
早期非小细胞肺癌立体定向放疗中国专家共识(2019版)
中华医学会放射肿瘤治疗学分会
中国抗癌协会肿瘤放射治疗学专业委员会
中国医师协会放射治疗医师分会
作者及单位信息
·
DOI： 10.3760/cma.j.cn112152-20200116-00039
Chinese expert consensus on stereotactic body radiation therapy for early stage non-small cell lung cancer (2019 Edition)
Radiation Oncology Branch of Chinese Medical Association
Radiation Therapy Committee of China Anti-Cancer Association
Radiation Oncologist Branch of Chinese Medical Doctor Association
Xing Ligang
Authors Info & Affiliations
Radiation Oncology Branch of Chinese Medical Association
Radiation Therapy Committee of China Anti-Cancer Association
Radiation Oncologist Branch of Chinese Medical Doctor Association
Xing Ligang
Department of Radiation Oncology, Shandong First Medical University Affiliated Cancer Hospital Shandong Cancer Hospital, Jinan 250117, China
·
DOI： 10.3760/cma.j.cn112152-20200116-00039
3163
1269
0
1
29
3
PDF下载
APP内阅读
摘要

立体定向体部放射治疗(SBRT)已成为早期非小细胞肺癌的重要根治性手段，尤其在不可手术或拒绝外科手术的患者中是首选治疗手段。在中国，SBRT正在普及，为了规范临床应用、推动技术水平提升和科研协作，特制定本专家共识。共识包括SBRT发展简介、物理技术要求、临床实施规范和特殊临床问题等，期望本共识在临床实践中可以为临床医师提供指导以及造福于广大肺癌患者。

癌，非小细胞肺;立体定向放疗;专家共识
ABSTRACT

Stereotactic body radiation therapy (SBRT) has become an important radical approach for early stage non-small cell lung cancer, especially for patients who are inoperable or refuse surgery. In China, this precision radiotherapy technology is being popularized. In order to standardize clinical application, improve the cooperation of technology and scientific research, this expert consensus is established. The consensus includes a brief introduction to the development of SBRT, the physical and technical requirements, the clinical implementation standardization and special clinical problems. The promotion and application of the consensus in clinical practice and constantly updated according to the latest research results will benefit more and more lung cancer patients.

Carcinoma, non-small-cell lung;Stereotactic body radiation therapy;Expert consensus
Xing Ligang, Department of Radiation Oncology, Shandong First Medical University Affiliated Cancer Hospital Shandong Cancer Hospital, Jinan 250117, China, Email: nc.defmoabc.liamdemglgnix
Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

中华医学会放射肿瘤治疗学分会,中国抗癌协会肿瘤放射治疗学专业委员会,中国医师协会放射治疗医师分会. 早期非小细胞肺癌立体定向放疗中国专家共识(2019版)[J]. 中华肿瘤杂志,2020,42(07)：522-530.

DOI:10.3760/cma.j.cn112152-20200116-00039

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

肺癌已成为我国发病率和死亡率最高的恶性肿瘤，中国国家癌症中心最新统计数据显示，每年新发肺癌病例已近80万例，因肺癌死亡高达60余万例，其中约80%为非小细胞肺癌(non-small cell lung cancer, NSCLC) [ 1 ]。预计到2025年，我国每年死于肺癌的人数将接近百万，严重危害公民健康。随着高危人群低剂量螺旋CT筛查的广泛应用，越来越多的早期肺癌得以检出。对于可手术的早期NSCLC，标准治疗模式为根治性手术；对于不可手术或拒绝手术的患者，局部放疗为标准治疗模式。过去20年中，放射治疗技术在呼吸运动管理、适形调强治疗计划和图像引导治疗等方面取得了长足发展，使立体定向体部放疗(stereotactic body radiation therapy, SBRT)或立体定向消融放疗(stereotactic ablative radiation therapy, SABR)治疗早期NSCLC成为可能。SBRT是指应用专用设备对体部(颅外)肿瘤进行准确定位和照射的治疗方法，放疗总剂量在保障充分保护正常组织的前提下在数天内完成 [ 2 , 3 ]，本共识中简称为立体定向放疗。在我国，该项精准放疗技术正在普及，为了规范临床应用、推动技术水平提升和科研协作，特制定早期非小细胞肺癌立体定向放疗中国专家共识，本共识临床实践推广应用中将根据最新研究成果不断更新。
参考文献
[1]
孙可欣，郑荣寿，张思维，等. 2015年中国分地区恶性肿瘤发病和死亡分析[J]. 中国肿瘤， 2019,28(1):1-11. DOI: 10.11735/j.issn.1004-0242.2019.01.A001 .
返回引文位置Google Scholar
百度学术
万方数据
Sun KX , Zheng RS , Zhang SW ,et al. Report of cancer incidence and mortality in different areas of China 2015[J]. China Cancer, 2019,28(1):1-11. DOI: 10.11735/j.issn.1004-0242.2019.01.A001 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[2]
Videtic GMM , Donington J , Giuliani M ,et al. Stereotactic body radiation therapy for early-stage non-small cell lung cancer: executive summary of an ASTRO evidence-based guideline[J]. Pract Radiat Oncol, 2017,7(5):295-301. DOI: 10.1016/j.prro.2017.04.014 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Guckenberger M , Andratschke N , Dieckmann K ,et al. ESTRO ACROP consensus guideline on implementation and practice of stereotactic body radiotherapy for peripherally located early stage non-small cell lung cancer[J]. Radiother Oncol, 2017,124(1):11-17. DOI: 10.1016/j.radonc.2017.05.012 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Lutz W , Winston KR , Maleki N . A system for stereotactic radiosurgery with a linear accelerator[J]. Int J Radiat Oncol Biol Phys, 1988,14(2):373-381. DOI: 10.1016/0360-3016(88)90446-4 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Lax I , Blomgren H , Näslund I ,et al. Stereotactic radiotherapy of malignancies in the abdomen. methodological aspects[J]. Acta Oncol, 1994,33(6):677-683. DOI: 10.3109/02841869409121782 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Tsai JS , Buck BA , Svensson GK ,et al. Quality assurance in stereotactic radiosurgery using a standard linear accelerator[J]. Int J Radiat Oncol Biol Phys, 1991,21(3):737-748. DOI: 10.1016/0360-3016(91)90694-y .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Xia T , Li H , Sun Q ,et al. Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable stage Ⅰ/Ⅱ non-small-cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2006,66(1):117-125. DOI: 10.1016/j.ijrobp.2006.04.013 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Timmerman R , Papiez L , McGarry R ,et al. Extracranial stereotactic radioablation: results of a phase Ⅰ study in medically inoperable stage Ⅰ non-small cell lung cancer[J]. Chest, 2003,124(5):1946-1955. DOI: 10.1378/chest.124.5.1946 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Timmerman R , Paulus R , Galvin J ,et al. Stereotactic body radiation therapy for inoperable early stage lung cancer[J]. JAMA, 2010,303(11):1070-1076. DOI: 10.1001/jama.2010.261 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Bezjak A , Paulus R , Gaspar LE ,et al. Safety and efficacy of a five-fraction stereotactic body radiotherapy schedule for centrally located non-small-cell lung cancer[J]. J Clin Oncol, 2019,37(15):1316-1325. DOI: 10.1200/JCO.18.00622 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Chang JY , Senan S , Paul MA ,et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage Ⅰ non-small-cell lung cancer: a pooled analysis of two randomised trials[J]. Lancet Oncol, 2015,16(6):630-637. DOI: 10.1016/S1470-2045(15)70168-3 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Kann BH , Verma V , Stahl JM ,et al. Multi-institutional analysis of stereotactic body radiation therapy for operable early-stage non-small cell lung carcinoma[J]. Radiother Oncol, 2019,134:44-49. DOI: 10.1016/j.radonc.2019.01.027 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Mutic S , Palta JR , Butker EK ,et al. Quality assurance for computed-tomography simulators and the computed-tomography-simulation process: report of the AAPM radiation therapy committee task group No. 66[J]. Med Phys, 2003,30(10):2762-2792. DOI: 10.1118/1.1609271 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Rasmussen B , Chu K , Tong S . SU-E-T-530: relative electron density phantom comparison[J]. Med Phys, 2012,39(6Part18):3827. DOI: 10.1118/1.4735619 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Klein EE , Hanley J , Bayouth J ,et al. Task group 142 report: quality assurance of medical accelerators[J]. Med Phys, 2009,36(9):4197-4212. DOI: 10.1118/1.3190392 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Ezzell GA , Galvin JM , Low D ,et al. Guidance document on delivery, treatment planning, and clinical implementation of IMRT: report of the IMRT subcommittee of the AAPM radiation therapy committee[J]. Med Phys, 2003,30(8):2089-2115. DOI: 10.1118/1.1591194 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Benedict SH , Yenice KM , Followill D ,et al. Stereotactic body radiation therapy: the report of AAPM task group 101[J]. Med Phys, 2010,37(8):4078-4101. DOI: 10.1118/1.3438081 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Guckenberger M , Wulf J , Mueller G ,et al. Dose-response relationship for image-guided stereotactic body radiotherapy of pulmonary tumors: relevance of 4D dose calculation[J]. Int J Radiat Oncol Biol Phys, 2009,74(1):47-54. DOI: 10.1016/j.ijrobp.2008.06.1939 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Onishi H , Shirato H , Nagata Y ,et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage Ⅰ non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study[J]. J Thorac Oncol, 2007,2(7Suppl 3):S94-100. DOI: 10.1097/JTO.0b013e318074de34 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Kong FM , Ritter T , Quint DJ ,et al. Consideration of dose limits for organs at risk of thoracic radiotherapy: atlas for lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus[J]. Int J Radiat Oncol Biol Phys, 2011,81(5):1442-1457. DOI: 10.1016/j.ijrobp.2010.07.1977 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Mayo CS , Moran JM , Bosch W ,et al. American association of physicists in medicine task group 263: standardizing nomenclatures in radiation oncology[J]. Int J Radiat Oncol Biol Phys, 2018,100(4):1057-1066. DOI: 10.1016/j.ijrobp.2017.12.013 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Feng M , Moran JM , Koelling T ,et al. Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer[J]. Int J Radiat Oncol Biol Phys, 2011,79(1):10-18. DOI: 10.1016/j.ijrobp.2009.10.058 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Hall WH , Guiou M , Lee NY ,et al. Development and validation of a standardized method for contouring the brachial plexus: preliminary dosimetric analysis among patients treated with IMRT for head-and-neck cancer[J]. Int J Radiat Oncol Biol Phys, 2008,72(5):1362-1367. DOI: 10.1016/j.ijrobp.2008.03.004 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Jabbour SK , Hashem SA , Bosch W ,et al. Upper abdominal normal organ contouring guidelines and atlas: a radiation therapy oncology group consensus[J]. Pract Radiat Oncol, 2014,4(2):82-89. DOI: 10.1016/j.prro.2013.06.004 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Hanna GG , Murray L , Patel R ,et al. UK consensus on normal tissue dose constraints for stereotactic radiotherapy[J]. Clin Oncol (R Coll Radiol), 2018,30(1):5-14. DOI: 10.1016/j.clon.2017.09.007 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Kong FS , Moiseenko V , Zhao J ,et al. Organs at risk considerations for thoracic stereotactic body radiation therapy: what is safe for lung parenchyma？[J]Int J Radiat Oncol Biol Phys, 2018,S0360-3016(18):34014-34018. DOI: 10.1016/j.ijrobp.2018.11.028 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Timmerman RD . An overview of hypofractionation and introduction to this issue of seminars in radiation oncology[J]. Semin Radiat Oncol, 2008,18(4):215-222. DOI: 10.1016/j.semradonc.2008.04.001 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Timothy AR , Martha M , Indrin JC ,et al. Application of critical volume-dose constraints for stereotactic body radiation therapy in NRG radiation therapy trials[J]. Int J Radiat Oncol Biol Phys, 2017,98(1):34-36. DOI: 10.1016/j.ijrobp.2017.01.204 .
返回引文位置Google Scholar
百度学术
万方数据
[29]
Takeda A , Kunieda E , Fujii H ,et al. Evaluation for local failure by 18F-FDG PET/CT in comparison with CT findings after stereotactic body radiotherapy (SBRT) for localized non-small-cell lung cancer[J]. Lung Cancer, 2013,79(3):248-253. DOI: 10.1016/j.lungcan.2012.11.008 .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Schwartz LH , Seymour L , Litière S ,et al. RECIST 1.1- standardisation and disease-specific adaptations: perspectives from the RECIST working group[J]. Eur J Cancer, 2016,62:138-145. DOI: 10.1016/j.ejca.2016.03.082 .
返回引文位置Google Scholar
百度学术
万方数据
[31]
Pierson C , Grinchak T , Sokolovic C ,et al. Response criteria in solid tumors (PERCIST/RECIST) and SUVmax in early-stage non-small cell lung cancer patients treated with stereotactic body radiotherapy[J]. Radiat Oncol, 2018,13(1):34. DOI: 10.1186/s13014-018-0980-7 .
返回引文位置Google Scholar
百度学术
万方数据
[32]
Brooks ED , Verma V , Chang JY . Does pathologic response equate to clinical response following SABR for early-stage NSCLC？[J]Front Oncol, 2019,9:551. DOI: 10.3389/fonc.2019.00551 .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Timmerman R , McGarry R , Yiannoutsos C ,et al. Excessive toxicity when treating central tumors in a phase Ⅱ study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer[J]. J Clin Oncol, 2006,24(30):4833-4839. DOI: 10.1200/JCO.2006.07.5937 .
返回引文位置Google Scholar
百度学术
万方数据
[34]
Meng MB , Wang HH , Zaorsky NG ,et al. Risk-adapted stereotactic body radiation therapy for central and ultra-central early-stage inoperable non-small cell lung cancer[J]. Cancer Sci, 2019,110(11):3553-3564. DOI: 10.1111/cas.14185 .
返回引文位置Google Scholar
百度学术
万方数据
[35]
Boily G , Filion É , Rakovich G ,et al. Stereotactic ablative radiation therapy for the treatment of early-stage non-small-cell lung cancer: CEPO review and recommendations[J]. J Thorac Oncol, 2015,10(6):872-882. DOI: 10.1097/JTO.0000000000000524 .
返回引文位置Google Scholar
百度学术
万方数据
[36]
Kilburn JM , Kuremsky JG , Blackstock AW ,et al. Thoracic re-irradiation using stereotactic body radiotherapy (SBRT) techniques as first or second course of treatment[J]. Radiother Oncol, 2014,110(3):505-510. DOI: 10.1016/j.radonc.2013.11.017 .
返回引文位置Google Scholar
百度学术
万方数据
[37]
Ogawa Y , Shibamoto Y , Hashizume C ,et al. Repeat stereotactic body radiotherapy (SBRT) for local recurrence of non-small cell lung cancer and lung metastasis after first SBRT[J]. Radiat Oncol, 2018,13(1):136. DOI: 10.1186/s13014-018-1080-4 .
返回引文位置Google Scholar
百度学术
万方数据
[38]
Kumar SS , McGarry RC . Management of local recurrences and regional failure in early stage non-small cell lung cancer after stereotactic body radiation therapy[J]. Transl Lung Cancer Res, 2019,8(Suppl 2):S213-S221. DOI: 10.21037/tlcr.2019.09.06 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
邢力刚， 山东第一医科大学附属肿瘤医院　山东省肿瘤医院放疗科， 济南　250117, Email: nc.defmoabc.liamdemglgnix
B
所有作者均声明不存在利益冲突
C
国家重点研发计划 (2018YFC1313220)
评论 （0条）
注册
登录
时间排序
暂无评论，发表第一条评论抢沙发
最新推荐
更多
效应修饰作用分析方法与案例解析系列（一）：流行病学和经典Meta分析中的效应修饰
刘凤琪 等
中华流行病学杂志 2024,45(01)
瘦素的外周效应
后瑞禛 等
中华糖尿病杂志 2023,15(03)
全面正确评价肠促胰素的生物学效应
潘琦 等
中华糖尿病杂志 2023,15(09)
130脐血移植GVHD与GVL效应的分子机制
杨会志 等
国外医学（免疫学分册） 2001,24(06)
MedAI助手（体验版）
文档即答
智问智答
机器翻译
回答内容由人工智能生成，我社无法保证其准确性和完整性，该生成内容不代表我们的态度或观点，仅供参考。
生成快照
文献快照

你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持：

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号
小中大