Retrospective Analysis Of Clinical Efficacy Of Gamma Knife Treatment For Early Lung Cancer

Objective To evaluate the clinical efficacy of stereotactic gamma ray body treatment system(referred to as body gamma knife)in the treatment of early lung cancer?Methods We collected the data of 60 patients diagnosed with early stage lung cancer(t1-2n0m0)who were treated with body gamma knife in our hospital from 2007 to 2017,including 32 patients with stage IA and 28 patients with stage IB.Basic information such as the patient's name,age,KPS score,lesion site,pathological type,stage,whether accompanied by cardiopulmonary diseases,treatment time,dose and dose segmentation mode were collected.The results of blood routine and liver and kidney function ion tests were collected before,during and after treatment.The dose segmentation modes of gamma knife therapy were as follows: dose of central lung cancer: 3-4gy /F× 10-20f;Dose of peripheral lung cancer:5Gy/F× 10-14 f,7-9gy /F× 8-10 f,among which 6 patients were treated 3 times a week,and the remaining patients were treated 5 times a week.The 50% isodose line was used to wrap the planned target area.After that,follow-up records were made according to the requirements to statistically analyze the short-term efficacy at 3 months after the treatment,Local control rate LCR at 3 years and 5 years,survival OS,cancer-specific survival CSS,side effects and prognostic factors.Results 1)the effective rate of treatment for 3 months was: 69%;The local control rates for 3years and 5 years were 93.3% and 67.4%,respectively.The overall survival rates were 60%and 42.5%,respectively.Tumor-specific survival rates were 79.5% and 52.8%.Among the 60 patients,27 survived and 33 died.Among them,17 died of myocardial infarction,pulmonary heart disease,cerebral hemorrhage and other medical diseases,and 16 died of tumor recurrence and metastasis.Patients with recurrence and metastasis can still be cured radically or prolong their survival after reasonable anti-tumor therapy such as reoperation,chemotherapy and/or radiotherapy.2)multivariate analysis showed that age and stage were the main factors affecting prognosis.Compared with patients aged ?70 and <70,the risk of death of the former was 5.2378 times that of the latter(P=0.0001).The risk of death in T2N0M0 patients was 3.1417 times higher than that in T1N0M0 patients(P=0.0029).3)side effects: 13(21.6%)patients had mild gastrointestinal reactions,such as nausea and vomiting,during radiotherapy;Fifteen(25%)of the patients developed cough and sputum without special treatment.Six(10%)patients developed pulmonary fibrosis in the radiotherapy area after six months of treatment,without shortness of breath and other symptoms,which did not affect normal life.No radiation esophagitis,bone marrow suppression,rib fracture and chest wall pain were observed.Conclusions(1)Gamma Knife is safe and effective in treating early lung cancer with high survival rate and low toxic side effects;The main factors affecting the prognosis of early lung cancer are age and stage;Will also affect survival,it is also very important to actively treat medical diseases;after gamma knife treatment of early lung cancer recurrence,active anti-tumor treatment can still partially cure or prolong the survival of patients.