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在肺癌中用于碳离子治疗的低氧向RBE和OER加权剂量优化

Yazhou Li¹, Yuanyuan Ma², Xinguo Liu²

¹Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China; Key Laboratory of Heavy Ion Radiation Biology and Medicine of Chinese Academy of Sciences, Lanzhou 730000, China; Gansu Provincial Key Laboratory of Ion Beam Medicine, Lanzhou 730000, China; University of Chinese Academy of Sciences, Beijing 100049, China; Gansu Provincial Hospital, Lanzhou 730000, China.

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

|January 12, 2026

概括

肺癌的低氧阻碍了放射治疗. 与传统的强度调节碳离子放射治疗 (IMCT) 相比,RBE和OER加权剂量 (ROWD) 优化框架改善了瘤控制概率和减少了肺部并发症.

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:

缺氧在肺癌中很常见,导致治疗耐药性和患者表现不佳.
碳离子放射治疗是肺癌的有前途的治疗方式.
优化放射性瘤放射治疗计划对于改善治疗疗效至关重要.

研究的目的:

评估RBE和OER加权剂量 (ROWD) 优化框架,用于肺癌患者的碳离子放射治疗.
为了比较ROWD优化的性能与常规强度调节碳离子放射治疗 (IMCT) 计划.
评估ROWD优化的影响,瘤控制概率 (TCP) 和正常组织并发症概率 (NTCP) 在低氧肺瘤.

主要方法:

对13名肺癌患者的18F-FMISO PET/CT图像进行了回顾性分析.
低氧导向ROWD计划的设计和与IMCT计划的比较,使用剂量-体积直方图 (DVH) 度量,物理剂量分布,剂量平均线性能量转移 (LETd),TCP和NTCP.
使用威尔科克森签名等级测试进行对对比的统计分析.

主要成果:

在规划瘤总体体积 (PGTV) 时,ROWD优化实现了>95%的处方剂量覆盖率,同时尊重风险器官 (OAR) 约束,即使在缺氧区域.
与IMCT相比,ROWD改善了低氧瘤体积 (HTV) 的物理剂量分布,LETd的变化很小.
在低氧区域,ROWD计划将瘤控制概率 (TCP) 恢复到76.20% (匹配正常水平),并将肺部并发症NTCP从2.01%降至1.34%,同时保持类似的OAR NTCP.

结论:

ROWD优化技术显示出显著的潜力,可以提高碳离子放射治疗在低氧区域的肺癌中的疗效.
ROWD优化提供了一种改进的方法来克服与瘤缺氧相关的治疗阻力.
这一框架可能会为接受碳离子放射治疗的肺癌患者带来更好的临床结果.

关键词:

强度调节的碳离子放射治疗.肺癌是一种肺癌.用RBE和OER加权的剂量优化.瘤缺氧是因为瘤缺氧.

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