子どものための体積調節弧療法による筋膜縮小全身放射線治療 - 単一センター体験センター

Hoong Hoong Ng¹, Munira Mohd Rejab^1,2, David Lee^1,3

¹Department of Clinical Oncology, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia.

|February 13, 2026

まとめ

ボリュメトリック・モデュレート・アーチ・セラピー・トータル・ボディ・放射線治療 (VMAT-TBI) は,幹細胞移植を受ける小児急性リンパ性白血病患者のための安全で効果的なコンディショニング療法です. このアプローチは,良いターゲットカバーと許容可能な毒性を示し,様々な環境での使用を支持しています.

科学分野:

放射線腫瘍学放射線腫瘍学
小児 hematology-oncology (小児血液腫瘍学) について
幹細胞移植幹細胞移植

背景:

全身放射線照射 (TBI) は,アロゲン性造血性幹細胞移植 (HSCT) 前における小児性急性リンパ性白血病 (ALL) の条件付け療法の重要な部分です.
ボリュメトリック・モジュレート・アーチ・セラピー-TBI (VMAT-TBI) は,TBIの提供における目標適合とリスクのある臓器の節約を強化するために実装されました.
本研究では,小児患者のVMAT-TBIとの最初の施設での経験を評価しています.

研究の目的:

ALLの小児患者におけるVMAT-TBIの可行性と有効性を評価する.
VMAT-TBI.の治療計画と提供指標を分析する.
VMAT-TBIに関連した早期の臨床結果と急性毒性を評価する.

主な方法:

2023年10月から2025年6月までの間にVMAT-TBIで治療された10人の小児患者の遡及レビュー.
患者は3日間にわたって6つの分断で12Gyを投与し,その後エトポシドを投与した.
収集されたデータには,治療計画パラメータ,出産時間,生存率,急性毒性が含まれていました.

主要な成果:

VMAT-TBI計画では,優れた対象範囲 (V100>90%) を達成し,リスクのある臓器の用量制約 (例えば,平均肺用量8.8 Gy) を満たしました.
平均ビームオン時間は分数あたり21.3分であり,画像誘導は3mm以内の精度と<1°の回転で確認されました.
1年間の全生存率と再発のない生存率は90%で,非再発死亡率は10%でした. 粘膜炎 (70%) と胃腸毒性 (50%の嘔吐,40%の下痢) が最も一般的な急性毒性でした.

結論:

VMAT-TBIは,HSCTを受ける小児ALL患者にとって安全で実行可能で効果的な治療方法です.
このテクニックは,堅固なターゲットカバーと受け入れられる急性毒性プロファイルを提供します.
これらの発見は,資源が限られた環境でも,VMAT-TBIの実施を支持します.

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