腹膜和肺剂量在肝脏高剂量速率间歇性胸膜疗法:一个剂量测量和毒性报告
Keerthaanaa Yogabalan1,2, Gokula Kumar Appalanaido1,2, Ch'ng Ewe Seng3
1Advanced Management of Liver Malignancies Program, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia.
Journal of contemporary brachytherapy
|April 7, 2025
概括
针对肝癌的高剂量间歇性胸膜疗法 (HDR-IBT) 表明隔膜和肺组织可以承受高剂量的辐射而不会产生显著的毒性. 建议在未来的肝脏HDR-IBT研究中进行进一步的标准化报告.
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:
- 肝脏瘤的治疗方法有多种,包括放射治疗.
- 高剂量速率间歇性支臂治疗 (HDR-IBT) 是针对局部肝脏瘤的一种先进技术.
- 了解与目标体积相邻的风险器官 (OAR) 的毒性概况对于治疗规划和患者安全至关重要.
研究的目的:
- 以追溯分析肝脏HDR-IBT之后的隔膜和肺组织的剂量量和临床毒性.
- 评估隔膜和肺组织对肝脏HDR-IBT期间输送的高剂量辐射的耐受性.
主要方法:
- 针对2018年9月至2023年6月期间治疗恶性肝瘤 (MLT) 患者的基于计算机断层扫描 (CT) 的肝脏HDR-IBT计划的回顾性审查.
- 在100%的处方异位剂量内识别患有隔膜和肺组织的患者.
- 隔膜和肺OAR的轮,以及剂量-体积参数的分析 (Dmax,D0.2cc,D0.5cc,D1cc,V30Gy,V50Gy).
- 从电子医疗记录中检索和分析临床毒性数据.
主要成果:
- 分析包括27名患者,隔膜和肺组织分别在43和36个MLT中接受100%处方异位剂.
- 处方剂量的中位数为单个分数中的25 Gy.
- 隔膜和肺接受了高的中位数剂量 (例如,Dmax分别为302 Gy和90 Gy) 和体积 (例如,V30Gy分别为1.1 cc和0.8 cc).
- 尽管辐射剂量高,但在23个月的中位随访期间,没有患者报告辐射诱导的隔膜或肺损伤症状.
结论:
- 这项研究是首次报告肝脏HDR-IBT中隔膜和肺组织的剂量-体积和毒性数据.
- 小体积的隔膜和肺组织表现出对极端辐射剂量的耐受性,明显高于立体体辐射疗法 (SBRT) 的范围.
- 对于未来的肝脏HDR-IBT研究,需要对隔膜和肺剂量体积参数进行标准化报告.
- 这些发现可能支持扩大支臂治疗的适用性,包括CT指导的跨胸肺支臂治疗.
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