在节点阳性宫癌中同时进行剂量升级的综合提升:5年在单一机构的经验
Elki Sze-Nga Cheung1, Frederick Chun-Him Law2, Nelson Tsz-Cheong Fung2
1Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Cancers
|September 28, 2023
概括
在局部晚期宫癌 (LACC) 中使用VMAT与SIB的剂量升级显示出出色的参与结节控制和区域控制. 这种先进的放射治疗技术为结节阳性LACC患者提供有效的治疗和低毒性.
科学领域:
- 辐射瘤学 辐射瘤学
- 妇科瘤学 妇科瘤学
- 医学物理 医学物理
背景情况:
- 局部晚期的宫癌 (LACC) 涉及节点,这对治疗提出了重大挑战.
- 优化向受影响的淋巴结输送辐射剂量对于改善患者的治疗结果至关重要.
- 具有同时集成提升 (SIB) 的体积调节弧疗法 (VMAT) 提供了精确的剂量升级能力.
研究的目的:
- 评估用VMAT与SIB在节点阳性LACC中对参与节点的剂量升级的临床结果.
- 评估该技术与图像引导自适应式支臂疗法 (IGABT) 结合使用的安全性和有效性.
主要方法:
- 54名结节阳性LACC患者的回顾性分析,这些患者接受了VMAT-SIB和IGABT (2018-2022) 的治疗.
- 节点增强输送和选择性准大动脉 (PAO) 辐射的标准化策略.
- 主要终点:参与节点控制 (INC) 和区域节点控制 (RNC).
主要成果:
- 优秀的INC仅在2%的提升量失败中实现.
- 两年的精算RNC,骨盆控制 (PC),地方区域控制 (LRC),无病生存率 (DFS) 和整体生存率 (OS) 分别为93%,87%,87%,78%和85%.
- 观察到≥3级急性 (2%) 和晚期 (4%) 毒性的低率.
结论:
- 带有SIB的VMAT可用于节点阳性LACC的安全有效的剂量升级.
- 这种方法表明了优秀的治疗结果,包括高节点控制和生存率.
- 这些发现支持使用VMAT-SIB作为LACC管理中的一个有价值的策略.
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