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膀满了,直肠空了吗? 在适应性放射治疗时代重新审视一个范式
Hanna Malygina1, Hendrik Auerbach2, Frank Nuesken2
1Department of Radiotherapy and Radiation Oncology, Saarland University Medical Centre, Kirrberger Str. 100, 66421, Homburg, Saar, Germany. hanna.malygina@uks.eu.
概括
在盆腔放射治疗期间保持完整的膀对于最佳的器官节约至关重要. 在适应性放射治疗中,直肠填充不至关重要,患者在治疗前不排泄可能会受益.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 病人遵守膀和直肠填充指令的盆腔放射治疗是具有挑战性的.
- 在线适应性放射治疗 (ART) 减少了对器官体积可再生性的需求.
研究的目的:
- 在ART期间分析膀和后直肠壁 (PRW) 在充满或空白膀和直肠条件下节省.
- 评估器官填充对放射治疗剂量指标的影响.
主要方法:
- 从14名接受Varian Ethos ART治疗的前列腺癌患者的280个分量的回顾性分析.
- 膀和PRW剂量指标 (V48Gy,V40Gy,V30Gy) 与器官体积的相关性.
主要成果:
- 满膀显著改善了膀节省 (V48Gy,V40Gy与填充相反相关).
- 在2/7的患者中,全直肠状况改善了PRW节省 (V30Gy),在5/7的患者中没有损害它.
- 平均V30Gy显示显著的PRW节省改善与一个完整的直肠 (p=0.039).
结论:
- 高膀填充在ART中对于最佳的膀节约仍然很重要.
- 由于缺乏剂量计优势,可以在ART中放弃直肠填充建议.
- 患者可能会受益于在治疗前不排泄,如果耐受的话.
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