tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2023-13-1-30-35tumors-1092Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCLINICAL NOTESВыбор режимов фракционирования при стереотаксической лучевой терапии больных ранними стадиями рака легкогоSelection of fractionation regimens of stereotactic body radiotherapy in patients with early stage lung cancerБартЮ. И.BartYu.  I.

Юлия И. Барт, врач-радиотерапевт

Москва

Yulia I. Bart, radiation therapist

Moscow

bart.yulia@yandex.ruГлибичукД. А.GlibichukD.  A.

Дмитрий А. Глибичук, аспирант кафедры онкологии

Москва

Dmitry A. Glibichuk, post-graduate student, Department of Oncology

Moscow

dr.glibichuk@gmail.comАбдулаеваР. Ш.AbdulaevaR.  Sh.

Рукият Ш. Абдулаева, ординатор 2-го года кафедры онкологии и лучевой терапии

Москва

Rukiyat Sh. Abdulaeva, second-year resident, Department of Oncology and Radiotherapy

Moscow

ruutlevi@gmail.comЧерныхМ. В.ChernykhM.  V.

Марина В. Черных, к. м. н., заведующий отделением радиотерапии, заместитель директора по лечебной работе НИИ КиЭР; доцент кафедры онкологии, радиотерапии и пластической хирургии

Москва

Marina V. Chernykh, MD, PhD, Head of the Radiotherapy Department, Deputy Medical Director; Associate Professor of the Department of Oncology, Radiotherapy and Plastic Surgery

Moscow

dr.chernich@mail.ruКалининА. Е.KalininА.  Е.

Алексей Е. Калинин, к. м. н., старший научный сотрудник, и. о. заведующего хирургическим отделением № 6 (абдоминальной онкологии)

Москва

Alexey E. Kalinin, MD, PhD, Senior Researcher, Acting Head of the Department of Abdominal Surgical Oncology No. 6

Moscow

main2001@inbox.ruБорисоваТ. Н.BorisovaT.  N.

Татьяна Н. Борисова, к. м. н., старший научный сотрудник отделения радиотерапии

Москва

Tatiana N. Borisova, MD, PhD, Senior Research Scientist of the Radiation Therapy Department

Moscow

tborisova111@gmail.comФГБУ «НМИЦ онкологии им. Н. Н. Блохина Минздрава РоссииРоссияN. N. Blokhin National Research Center of OncologyRussian FederationФГБУ «Российский университет дружбы народов» Минздрава РоссииРоссияPeoples’ Friendship University of RussiaRussian FederationФГАОУ ВО «РНИМУ им. Н. И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГБУ «НМИЦ онкологии им. Н. Н. Блохина Минздрава России; ФГАОУ ВО «Первый МГМУ им. И. М. Сеченова» Минздрава РоссииРоссияN. N. Blokhin National Research Center of Oncology; Sechenov First Moscow State Medical UniversityRussian Federation2023160220231313035Copyright © Барт Ю.И., Глибичук Д.А., Абдулаева Р.Ш., Черных М.В., Калинин А.Е., Борисова Т.Н., 20232023Барт Ю.И., Глибичук Д.А., Абдулаева Р.Ш., Черных М.В., Калинин А.Е., Борисова Т.Н.Bart Y. ., Glibichuk D.A., Abdulaeva R.S., Chernykh M.V., Kalinin А.Е., Borisova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/1092

Стереотаксическая лучевая терапия больных ранними стадиями немелкоклеточного рака легкого была, есть и останется основной темой для дискуссии между радиотерапевтами и хирургами. Несмотря на представленные положительные результаты лечения в отдельных крупных исследованиях по эффективности стереотаксической лучевой терапии (Stereotactic Body Radiotherapy — SBRT), ее назначение вместо хирургического лечения не всегда может быть безоговорочным решением. Однако стереотаксическая радиотерапия открывает новые возможности лечения в случае отказа пациента от хирургического лечения или невозможности проведения операции. Это стало возможно благодаря высокой точности современных линейных ускорителей, которые позволяют снизить токсичность лучевой терапии, добиться примерно равных показателей общей выживаемости в сравнении с хирургическим лечением.

Stereotactic body radiotherapy for early stage non-small-cell lung cancer was, is, and will remain the key subject of discussions between radiation oncologists and surgeons. Despite the positive treatment outcomes reported in some large studies on efficacy of the stereotactic radiotherapy, its use instead of surgery may not always be an unconditional decision. However, stereotactic radiotherapy opens new treatment options in patients who are inoperable or refused surgery. This is possibly due to the high accuracy of modern linear accelerators, which allow to reduce the toxicity of radiotherapy and achieve an almost identical overall survival rate compared to surgery.

стереотаксическая лучевая терапиярак легкихstereotactic body radiotherapylung cancerReferencesEttinger D., Wood D., Aisner D., and Akerley W., NCCN Guidelines Non-Small Cell Lung Cancer Version 5.2022, https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450, 2022.Ettinger D., Wood D., Aisner D., and Akerley W., NCCN Guidelines Non-Small Cell Lung Cancer Version 5.2022, https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450, 2022.O. Cho, Y. T. Oh, M. Chun, O. K. Noh, and J. S. Heo, Prognostic implication of FEV1 / FVC ratio for limited-stage small cell lung cancer, J Thorac Dis, vol. 10, no. 3, pp. 1797–1805, Mar. 2018, doi: 10.21037/jtd.2018.02.14.O. Cho, Y. T. Oh, M. Chun, O. K. Noh, and J. S. Heo, Prognostic implication of FEV1 / FVC ratio for limited-stage small cell lung cancer, J Thorac Dis, vol. 10, no. 3, pp. 1797–1805, Mar. 2018, doi:10.21037/jtd.2018.02.14.D. J. Raz, J. A. Zell, S. H. I. Ou, D. R. Gandara, H. Anton-Culver, and D. M. Jablons, Natural history of stage I non-small cell lung cancer: Implications for early detection, Chest, vol. 132, no. 1, pp. 193–199, 2007, doi: 10.1378/chest.06–3096.D. J. Raz, J. A. Zell, S. H. I. Ou, D. R. Gandara, H. Anton-Culver, and D. M. Jablons, Natural history of stage I nonsmall cell lung cancer: Implications for early detection, Chest, vol. 132, no. 1, pp. 193–199, 2007, doi:10.1378/chest.06–3096.J. D. Cox, J. Stetz, and T. F. Pajak, TOXICITY CRITERIA OF THE RADIATION THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER (EORTC), 1995.J. D. Cox, J. Stetz, and T. F. Pajak, toxicity criteria of the radiation therapy oncology group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC), 1995.P. Lee et al., Local Control After Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer, Int J Radiat Oncol Biol Phys, vol. 110, no. 1, pp. 160–171, May 2021, doi: 10.1016/j.ijrobp.2019.03.045.P. Lee et al., Local Control After Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer, Int J Radiat Oncol Biol Phys, vol. 110, no. 1, pp. 160–171, May 2021, doi:10.1016/j.ijrobp.2019.03.045.R. D. Timmerman et al., Long-Term results of stereotactic body radiation therapy in medically inoperable stage i non-small cell lung cancer, JAMA Oncology, vol. 4, no. 9. American Medical Association, pp. 1287–1288, Sep. 01, 2018. doi: 10.1001/jamaoncol.2018.1258.R. D. Timmerman et al., Long-Term results of stereotactic body radiation therapy in medically inoperable stage i non-small cell lung cancer, JAMA Oncology, vol. 4, no. 9. American Medical Association, pp. 1287–1288, Sep. 01, 2018. doi:10.1001/jamaoncol.2018.1258.H. Chen et al., Treatment-Related Toxicity in Patients With Early-Stage Non-Small Cell Lung Cancer and Coexisting Interstitial Lung Disease: A Systematic Review, International Journal of Radiation Oncology Biology Physics, vol. 98, no. 3. Elsevier Inc., pp. 622–631, Jul. 01, 2017. doi: 10.1016/j.ijrobp.2017.03.010.H. Chen et al., Treatment-Related Toxicity in Patients With Early-Stage Non-Small Cell Lung Cancer and Coexisting Interstitial Lung Disease: A Systematic Review, International Journal of Radiation Oncology Biology Physics, vol. 98, no. 3. Elsevier Inc., pp. 622–631, Jul. 01, 2017. doi:10.1016/j.ijrobp.2017.03.010.R. Timmerman et al., Stereotactic Body Radiation Therapy for Inoperable Early Stage Lung Cancer, JAMA Oncol, vol. 303, no. 11, p. 1070, 2010, doi:10.1001/jama.2010.261.R. Timmerman et al., Stereotactic Body Radiation Therapy for Inoperable Early Stage Lung Cancer, JAMA Oncol, vol. 303, no. 11, p. 1070, 2010, doi:10.1001/jama.2010.261.Ассоциация онкологов России, Злокачественное новообразование бронхов и легкого, Клинические рекомендации, 2021.Ассоциация онкологов России, Злокачественное новообразование бронхов и легкого, Клинические рекомендации, 2021.G. M. M. Videtic et al., Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive Summary of an ASTRO Evidence-Based Guideline, Pract Radiat Oncol, vol. 7, no. 5, pp. 295–301, Sep. 2017, doi: 10.1016/j.prro.2017.04.014.G. M. M. Videtic et al., Stereotactic body radiation therapy for early-stage non-small cell lung cancer: Executive Summary of an ASTRO Evidence-Based Guideline, Pract Radiat Oncol, vol. 7, no. 5, pp. 295–301, Sep. 2017, doi:10.1016/j.prro.2017.04.014.N. Shaverdian, P. C. Wang, M. Steinberg, and P. Lee, The patient’s perspective on stereotactic body radiation therapy (SBRT) vs. surgery for treatment of early stage non-small cell lung cancer (NSCLC), Lung Cancer, vol. 90, no. 2, pp. 230–233, Nov. 2015, doi: 10.1016/j.lungcan.2015.07.009.N. Shaverdian, P. C. Wang, M. Steinberg, and P. Lee, The patient’s perspective on stereotactic body radiation therapy (SBRT) vs. surgery for treatment of early stage non-small cell lung cancer (NSCLC), Lung Cancer, vol. 90, no. 2, pp. 230–233, Nov. 2015, doi:10.1016/j.lungcan.2015.07.009.R. Timmerman 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, Journal of Clinical Oncology, vol. 24, no. 30, pp. 4833–4839, Oct. 2006, doi: 10.1200/JCO.2006.07.5937.R. Timmerman 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, Journal of Clinical Oncology, vol. 24, no. 30, pp. 4833–4839, Oct. 2006, doi:10.1200/JCO.2006.07.5937.M. Trovo, A. Linda, I. el Naqa, C. Javidan-Nejad, and J. Bradley, Early and late lung radiographic injury following stereotactic body radiation therapy (SBRT), Lung Cancer, vol. 69, no. 1, pp. 77–85, Jul. 2010, doi: 10.1016/j.lungcan.2009.09.006.M. Trovo, A. Linda, I. el Naqa, C. Javidan-Nejad, and J. Bradley, Early and late lung radiographic injury following stereotactic body radiation therapy (SBRT), Lung Cancer, vol. 69, no. 1, pp. 77–85, Jul. 2010, doi:10.1016/j.lungcan.2009.09.006.M. Guckenberger et al., Lack of a dose-effect relationship for pulmonary function changes after stereotactic body radiation therapy for early-stage non-small cell lung cancer, Int J Radiat Oncol Biol Phys, vol. 85, no. 4, pp. 1074–1081, Mar. 2013, doi: 10.1016/j.ijrobp.2012.09.016.M. Guckenberger et al., Lack of a dose-effect relationship for pulmonary function changes after stereotactic body radiation therapy for early-stage non-small cell lung cancer, Int J Radiat Oncol Biol Phys, vol. 85, no. 4, pp. 1074–1081, Mar. 2013, doi:10.1016/j.ijrobp.2012.09.016.NCI, Common Terminology Criteria for Adverse Events (CTCAE) v3.0, https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcaev3.pdf, 2006.NCI, Common Terminology Criteria for Adverse Events (CTCAE) v3.0, https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcaev3.pdf, 2006.Y. Xiao et al., Dosimetric Evaluation of Heterogeneity Corrections for RTOG 0236: Stereotactic Body Radiotherapy of Inoperable Stage I-II Non–Small-Cell Lung Cancer, International Journal of Radiation Oncology*Biology*Physics, vol. 73, no. 4, pp. 1235–1242, Mar. 2009, doi: 10.1016/j.ijrobp.2008.11.019.Y. Xiao et al., Dosimetric Evaluation of Heterogeneity Corrections for RTOG 0236: Stereotactic Body Radiotherapy of Inoperable Stage I-II Non–Small-Cell Lung Cancer, International Journal of Radiation Oncology*Biology*Physics, vol. 73, no. 4, pp. 1235–1242, Mar. 2009, doi:10.1016/j.ijrobp.2008.11.019.J. Nyman et al., SPACE – A randomized study of SBRT vs conventional fractionated radiotherapy in medically inoperable stage I NSCLC, Radiotherapy and Oncology, vol. 121, no. 1, pp. 1–8, Oct. 2016, doi: 10.1016/j.radonc.2016.08.015.J. Nyman et al., SPACE – A randomized study of SBRT vs conventional fractionated radiotherapy in medically inoperable stage I NSCLC, Radiotherapy and Oncology, vol. 121, no. 1, pp. 1–8, Oct. 2016, doi:10.1016/j.radonc.2016.08.015.H. West and J. O. Jin, Performance status in patients with cancer, JAMA Oncology, vol. 1, no. 7. American Medical Association, p. 998, Oct. 01, 2015. doi: 10.1001/jamaoncol.2015.3113.H. West and J. O. Jin, Performance status in patients with cancer, JAMA Oncology, vol. 1, no. 7. American Medical Association, p. 998, Oct. 01, 2015. doi:10.1001/jamaoncol.2015.3113.A. Bezjak et al., Safety and Efficacy of a Five-Fraction Stereotactic Body Radiotherapy Schedule for Centrally Located Non-Small-Cell Lung Cancer: NRG Oncology / RTOG 0813 Trial, 2019. Accessed: Nov. 08, 2022. [Online]. Available: https://doi.org/10.1200/JCO.18.00622.A. Bezjak et al., Safety and Efficacy of a Five-Fraction Stereotactic Body Radiotherapy Schedule for Centrally Located Non-Small-Cell Lung Cancer: NRG Oncology / RTOG 0813 Trial, 2019. Accessed: Nov. 08, 2022. [Online]. Available: https://doi.org/10.1200/JCO.18.00622.T. K. Nguyen et al., Optimal imaging surveillance after stereotactic ablative radiation therapy for early-stage non-small cell lung cancer: Findings of an International Delphi Consensus Study, Pract Radiat Oncol, vol. 8, no. 2, pp. e71–e78, Mar. 2018, doi: 10.1016/j.prro.2017.10.008.T. K. Nguyen et al., Optimal imaging surveillance after stereotactic ablative radiation therapy for early-stage non-small cell lung cancer: Findings of an International Delphi Consensus Study, Pract Radiat Oncol, vol. 8, no. 2, pp. e71–e78, Mar. 2018, doi:10.1016/j.prro.2017.10.008.R. Cooke et al., Stereotactic body radiotherapy for moderately central and ultra-central oligometastatic disease: Initial outcomes, Tech Innov Patient Support Radiat Oncol, vol. 13, pp. 24–30, Mar. 2020, doi: 10.1016/j.tipsro.2020.01.002.R. Cooke et al., Stereotactic body radiotherapy for moderately central and ultra-central oligometastatic disease: Initial outcomes, Tech Innov Patient Support Radiat Oncol, vol. 13, pp. 24–30, Mar. 2020, doi:10.1016/j.tipsro.2020.01.002.

The authors declare that there are no conflicts of interest present.