Patients with lung cancer complicated by interstitial pneumonia (IP) often lose treatment options early owing to acute exacerbation of IP concerns. Carbon-ion radiotherapy (CIRT) can provide superior tumor control and low toxicity at high dose concentrations. We conducted a retrospective analysis of the efficacy and tolerability of a single-fraction CIRT using 50 Gy for IP-complicated lung cancer. The study included 50 consecutive patients treated between April 2013 and September 2022, whose clinical stage of lung cancer (UICC 7th edition) was 1A:1B:2A:2B = 32:13:4:1. Of these, 32 (64%) showed usual interstitial pneumonia patterns. With a median follow-up of 23.5 months, the 3-year overall survival (OS), cause-specific survival, and local control rates were 45.0, 75.4, and 77.8%, respectively. The median lung V5 and V20 were 10.0 and 5.2%, respectively (mean lung dose, 2.6 Gy). The lung dose, especially lung V20, showed a strong association with OS (p= 0.0012). Grade ≥ 2 pneumonia was present in six patients (13%), including two (4%) with suspected grade 5. CIRT can provide a relatively safe and curative treatment for patients with IP-complicated lung cancer. However, IP increases the risk of severe radiation pneumonitis, and further studies are required to assess the appropriate indications.
合并间质性肺炎（IP）的肺癌患者常因担心IP急性加重而早期失去治疗选择。碳离子放射治疗（CIRT）能够通过高剂量集中照射实现优异的肿瘤控制效果及较低的毒性反应。本研究对单次50 Gy剂量CIRT治疗IP合并肺癌的疗效与耐受性进行了回顾性分析。研究纳入2013年4月至2022年9月期间连续收治的50例患者，其肺癌临床分期（UICC第7版）分布为1A:1B:2A:2B = 32:13:4:1。其中32例（64%）呈现普通型间质性肺炎影像模式。中位随访时间23.5个月，3年总生存率、疾病特异性生存率和局部控制率分别为45.0%、75.4%和77.8%。中位肺V5和V20分别为10.0%和5.2%（平均肺剂量2.6 Gy）。肺照射剂量，特别是肺V20，与总生存率呈显著相关性（p=0.0012）。6例患者（13%）出现≥2级放射性肺炎，其中2例（4%）疑似为5级肺炎。CIRT可为IP合并肺癌患者提供相对安全且根治性的治疗方案，但IP会增加重度放射性肺炎风险，仍需进一步研究以评估其适宜适应症。
肿瘤(癌症)患者之家