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带有盆腔SBRT的急性肠炎:肠道划界方法的影响

Akshay Dinesan¹, Maneesh Singh¹, Prachi Mehta¹

¹Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Homi Bhabha National Institute (HBNI), Mumbai, India.

Clinical and translational radiation oncology

|February 25, 2025

概括

针对前列腺癌的全骨盆SBRT可以导致肠炎. 这项研究发现,无论肠道的轮如何,患有急性肠道毒性患者和没有患有急性肠道毒性患者之间的肠道辐射剂量没有显著差异.

科学领域:

辐射瘤学辐射瘤学
医学物理医学物理
胃肠病学胃肠病学

背景情况:

针对前列腺癌和盆腔癌的立体性身体辐射疗法 (SBRT) 与大约25%的患者的急性肠炎有关.
了解肠道剂量测量对于最大限度地减少全骨盆SBRT (WP-SBRT) 中的毒性至关重要.

研究的目的:

在接受WP-SBRT的患者中,通过各种肠道划分方法调查肠道剂量测量.
为了比较经历过急性肠道毒性和没有经历过急性肠道毒性患者之间的剂量测量.

主要方法:

一项前性研究包括使用WP-SBRT治疗的高风险前列腺癌患者.
患者被分为病例 (1-2级急性肠炎) 和对照组 (无毒性).
在计划CT扫描时,评估了七种肠道轮方法,包括肠袋,小肠/大肠环和边缘环 (0.5-1.5厘米).

主要成果:

在102名患者中,23名 (22.5%) 患有1-2级急性肠炎;23名没有毒性的类似患者作为对照.
剂量-体积组图 (DVH) 和客观剂量-体积参数 (V7 Gy,V14 Gy,V25 Gy) 显示,在任何划分方法中,病例和对照组之间没有统计学上显著的差异.
大约20%的WP-SBRT治疗患者在使用肠袋剂量限制时经历了急性肠炎 (V7 < 1500 cc,V14 < 500 cc,V25 < 50 cc).

结论:

根据WP-SBRT中前列腺癌的各种肠道划分方法,计划的肠道剂量没有显著差异.
目前的肠道划分策略似乎无法预测这种患者队列中的急性肠道毒性.

关键词:

急性肠炎是一种急性肠炎.肠道轮造型肠道轮造型高风险的前列腺癌.在WP-SBRT中使用WP-SBRT.

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