With the development of radiation technology, stereotactic body radiation therapy (SBRT) has been widely used in early stage non-small cell lung cancer (NSCLC). It is not only the standard therapy for medically inoperable early-stage NSCLC, but also one of the therapies for operable early-stage NSCLC. Radiation pneumonitis (RP) is one of the most common adverse effects after SBRT, it may reduce the patients' quality of life, even cause treatment failure. Therefore, in order to improve the patients' quality of life and enhance local control rate of tumor, it is important to reduce the risk of RP. The unique fractionation schemes and the dose distribution of SBRT make it not only different from conventional fraction radiation therapy in treatment outcomes, but also in the incidence of radiation pneumonitis. This article reviews the applying of SBRT for early stage NSCLC, the incidence of radiation pneumonitis, radiological appearance after SBRT and predictive factors.
随着放疗技术的进步，立体定向放射治疗（stereotactic body radiation therapy, SBRT）在早期非小细胞肺癌（non-small cell lung cancer, NSCLC）中得到了广泛应用，其不仅是不可手术的早期NSCLC的标准治疗方法，也是可手术的早期NSCLC的治疗方法之一。放射性肺炎（radiation pneumonitis, RP）是SBRT治疗后最常见的并发症。SBRT独特的分割计划和剂量分布使其不仅在治疗效果上和常规分割放疗不同，而且治疗后引起的RP和常规分割放疗引起的RP也有所不同。RP的发生可降低患者的生活质量，甚至导致治疗失败。因此，降低RP的风险对提高患者的生活质量和肿瘤的控制率有重要意义。本文就SBRT在早期NSCLC治疗中应用、治疗后RP的发生率、影像学表现以及预测因素方面作一综述。