适应性放射治疗在有限阶段小细胞肺癌同时进行化学放射治疗期间的作用
Beyza Sirin Ozdemir1, Ali A Yavuz
1Department of Radiation Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Indian journal of cancer
|July 17, 2024
概括
适应性放射治疗 (ART) 在小细胞肺癌 (SCLC) 患者中显著减少瘤体积. 这种方法对有风险的器官有好处,并且可以在治疗期间增加剂量.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 在瘤学瘤学.
背景情况:
- 传统的分离化疗通常会在有限阶段的小细胞肺癌 (SCLC) 中诱导瘤缩.
- 在放射治疗 (RT) 期间评估瘤总体积 (GTV) 变化对于优化治疗至关重要.
- 适应性放射疗法 (ART) 具有增加剂量或在SCLC中节省正常组织的潜力.
研究的目的:
- 为了评估SCLC的RT期间的GTV变化.
- 调查ART对剂量升级和正常组织节约的有用性.
- 为了将GTV减少与ART益处相关联.
主要方法:
- 10名SCLC患者在23.4 Gy和41.4 Gy后接受了CT扫描.
- 在重复的CT扫描中划出了GTV.
- 创建了治疗计划,并没有适应瘤缩;进行了剂量和体积分析.
主要成果:
- 在13个分数后,平均GTV减少为58.5%,在23个分数后为70% (P < 0.001).
- ART导致肺平均剂量 (8.7%),肺平均V20 (5%),肺平均V5 (10%),脊髓平均剂量 (21 cGy),食道平均V50 (19%) 和心脏平均V42 (13%) 的相对显著下降.
- 在初始瘤体积≥30厘米3时,ART的益处最为明显,并且与GTV减少直接相关.
结论:
- 对于SCLC来说,ART对有风险的器官 (OAR) 提供了显著的优势.
- 在SCLC患者中,ART有助于剂量升级.
- 在RT期间减少GTV是SCLC成功实施ART的关键因素.
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