Effects of target coverage on local recurrence in stereotactic body radiotherapy for early-stage lung squamous cell carcinoma.

IF 2.1 4区医学 Japanese Journal of Radiology Pub Date : 2025-06-01 Epub Date: 2025-02-22 DOI:10.1007/s11604-025-01749-x

Shuou Sudo, Nozomi Kita, Natsuo Tomita, Taiki Takaoka, Dai Okazaki, Masanari Niwa, Akira Torii, Seiya Takano, Masanosuke Oguri, Akane Matsuura, Machiko Ukai, Akio Niimi, Akio Hiwatashi

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Abstract

Background and purpose: This study investigated effects of target coverage on local recurrence (LR) in stereotactic body radiotherapy (SBRT) for early-stage lung squamous cell carcinoma (SCC).

Materials and methods: Patients with clinical stage IA1-IIA lung SCC treated with SBRT were included in the analysis. Doses of 48-52 Gy were prescribed to the isocenter of the planning target volume according to the tumor diameter. The primary endpoint was LR. To examine the independent effects of dosimetric factors on LR after adjustment for clinical factors, Fine-Gray model with death as a competing risk was used for evaluation.

Results: Among all 59 patients analyzed, the median follow-up was 42 months. The 3-year LR rate was 24.0%. Univariate analysis of clinical factors showed that biologically effective dose calculated with an α/β value of 10 (BED₁₀) was associated with LR (p = 0.033). After adjustment for clinical factors, internal target volume (ITV) Dmean was associated with LR (p = 0.049). Subgroup analysis was performed for each prescribed dose group. The results of Fine-Gray model and receiver operating characteristic curve analysis showed that ITV Dmean > 100% of the prescribed dose was the best indicator of preventing LR.

Conclusions: ITV coverage may be particularly important in SBRT for early-stage lung SCC.

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靶覆盖对早期肺鳞状细胞癌立体定向放射治疗局部复发的影响。

背景与目的：本研究探讨立体定向放射治疗（SBRT）早期肺鳞状细胞癌（SCC）中靶区覆盖对局部复发（LR）的影响。材料与方法：纳入经SBRT治疗的临床分期IA1-IIA期肺鳞状细胞癌患者。根据肿瘤直径，在计划靶体积等中心给予48 ~ 52 Gy剂量。主要终点为LR。在调整临床因素后，为了检验剂量学因素对LR的独立影响，采用以死亡为竞争风险的Fine-Gray模型进行评估。结果：分析的59例患者中位随访时间为42个月。3年期LR利率为24.0%。临床因素单因素分析显示，以α/β值10计算的生物有效剂量（BED10）与LR相关（p = 0.033）。调整临床因素后，内靶容积（ITV） Dmean与LR相关（p = 0.049）。各处方剂量组进行亚组分析。Fine-Gray模型和受试者工作特征曲线分析结果显示，ITV Dmean > 100%处方剂量是预防LR的最佳指标。结论：在早期肺鳞状细胞癌的SBRT中，ITV覆盖可能特别重要。

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来源期刊

Japanese Journal of Radiology Medicine-Radiology, Nuclear Medicine and Imaging

自引率

4.80%

发文量

133

期刊介绍： Japanese Journal of Radiology is a peer-reviewed journal, officially published by the Japan Radiological Society. The main purpose of the journal is to provide a forum for the publication of papers documenting recent advances and new developments in the field of radiology in medicine and biology. The scope of Japanese Journal of Radiology encompasses but is not restricted to diagnostic radiology, interventional radiology, radiation oncology, nuclear medicine, radiation physics, and radiation biology. Additionally, the journal covers technical and industrial innovations. The journal welcomes original articles, technical notes, review articles, pictorial essays and letters to the editor. The journal also provides announcements from the boards and the committees of the society. Membership in the Japan Radiological Society is not a prerequisite for submission. Contributions are welcomed from all parts of the world.