哈罗德·不伦纳答：
The limitations of SBRT will be such that the GTV gets 100-110% and as there is a rapid fall off that covers a minimal CTV, so that area will receive 90% of the tumor dose. The doses are from 5x800 Cgy (once weekly) to 1800 Cgy x2 , but this will vary with the size of the tumor and the pathology diagnosis.
SBRT多半会受制于GTV，以让GTV受到100至110%放射剂量。除此之外，放射强度很快会下跌。因而一小部分的CTV会受到90%剂量。剂量大约为5x800 Cgy （每周一次）至1800 Cgy x2，但剂量需按照肿瘤体积及病理诊断。
orienthwd问：
立体定向放射治疗对非小细胞肺癌确实是一个不错的选择，效果不错。
哈罗德·不伦纳答：
Orienthwd;I agree.我也这样认为。
474073075问：
如何尽早，简单的检测出非小细胞癌， 中国的基层医院检测设备有限。
哈罗德·不伦纳答：
The first is to do a simple Chest Xray,and if there is a suspicious lesion go on to CT chest, and in the meanwhile get sputum specimens for cytology.
第一步是进行胸部X光。若有可疑的病灶，该再进行CT扫描，同时也可以取得痰标本。
yizhao76问：
I have one question. My name is YIZHAO MICHAEL LIU, a medical practitioner educated in China, but primarily involved in clinical practice abroad.
My question is Which index you do use to evaluate the effectiveness of therapies including radioactive for non small cell lung cancer?
In addition, is the new radioactive therapy able to produce comparable result to the following chart upon prognosis?
Non-small-cell lung carcinoma survival by stage(1997)[15]
Grouping Survival rate (percents)
One year Two years Three years Four years Five years
IA 82% 79% 71% 67% 61%
IB 72% 54% 46% 41% 38%
IIA 79% 49% 38% 34% 34%
IIB 59% 41% 33% 26% 24%
IIIA 50% 25% 18% 14% 13%
IIIB 34% 13% 7% 6% 5%
IV 19% 6% 2% 2% 1%
哈罗德·不伦纳答：
The usual 3 and 5 year survival figures are used. As Lung cancer is so aggressive simple survival is enough to measure success.The SBRT gives comparable survival figures to surgery up to 5 years.
我们通常使用3年和5年的生存率数据。因为肺癌很具侵袭力，生存率足以证明治疗是否有效。根据5年生存率，SBRT与手术的效果差不多。
xieye问：
我认为将SBRT用于早期NSCLC的治疗是一个很好的选择，但是有一个问题想请教您一下：在治疗前的分期一般都是临床分期，所以，在治疗前我们如何能够确定患者没有纵隔淋巴结转移？（也就是说，如何能够确定患者就是一期病人？）
哈罗德·不伦纳答：
if the nodes are very small but suspicious, you may have to do transbronchial or transtracheal U/S guided Fine Needle Aspiration, or a mediastinoscopy. If the glands are larger than 1.5 cm then a PET CT will help to delineate the areas of spread.
若结节非常小而且可疑，您可能需要进行气管或支气管的超声引导细针细胞穿刺术，或者纵隔镜检。若腺体大于1.5厘米，可以使用PET CT来显示肿瘤的具体面积。
9798问：
请问，SBRT对非小细胞肺癌放疗时，对肺等正常组织如何限量？具体如何？是否如直线加速器一样？原因？
哈罗德·不伦纳答：
We are writing about the use of Linear accelerators, and the machines have excellent definition of fields to a very small area. No other structures are getting more than 30% of the tumor doses, and usually less.
SBRT也使用直线加速器，这种机器对极小区域的定位准确性相当高。其他组织所受到的放射剂量不会超过肿瘤所受剂量的30%（通常低于此数字）。
