MICROSCOPIC AND MACROSCOPIC TUMOR AND PARENCHYMAL EFFECTS OF LIVER STEREOTACTIC BODY RADIOTHERAPY
MICROSCOPIC AND MACROSCOPIC TUMOR AND PARENCHYMAL EFFECTS OF LIVER STEREOTACTIC BODY RADIOTHERAPY
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DOI：
10.1016/j.ijrobp.2008.07.032
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发表时间：
2009-04-01
影响因子：
7
通讯作者：
Schefter, T. E.
中科院分区：
文献类型：
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作者：
Olsen, C. C.;Welsh, J.;Schefter, T. E.
目的：描述的组织学和体积的变化后，正常的肝组织立体定向体放射治疗（SBRT）的肝transferase.Methods和材料：前和后SBRT成像研究进行了分析，以评估SBRT对正常肝体积（NLV）在15例患者治疗的前瞻性临床试验的影响。另外两名患者进行了探索性手术后，SBRT和组织学分析的照射肝脏进行表征SBRT.Results的病理影响：在15例定量研究，总NLV短暂下降后2-3个月SBRT，然后开始再生后3-8个月SBRT。观察到最大效果时的NLV减少中位数为315 cm（3）（范围，125-600）或19%（范围，13-33%）。在评价的几个剂量学参数中，接受30戈伊的NLV百分比的线性相关性最强，可作为最大NLV减少的预测因子（r（2）= 0.72）。SBRT后2个月和8个月观察到的组织学变化表现出不同的区域的组织损伤符合本地化的veno-occlusive diseases.Conclusion：明确界定的局灶性肝实质变化后，SBRT（表现为放射学和组织学）在高剂量区是一致的阈值剂量诱导的一组现象。相比之下，NLV降低的更全面的影响（大致与整个器官剂量参数成比例）更接近放射生物学平行结构确定的影响。这些观察结果表明，模拟肝脏SBRT后的正常组织效应可能需要不同的控制方程，不同类别的影响。(C)2009爱思唯尔公司
Purpose: To describe the histologic and volumetric changes in normal liver tissue after stereotactic body radiotherapy (SBRT) for liver metastases.Methods and Materials: Pre- and post-SBRT imaging studies were analyzed to evaluate the effect of SBRT on normal liver volume (NLV) in 15 patients treated in a prospective clinical trial. Two other patients underwent exploratory surgery after SBRT and histologic analyses of the irradiated liver were performed to characterize the pathologic effects of SBRT.Results: In the 15 patients studied quantitatively, the total NLV had decreased transiently at 2-3 months after SBRT and then began to regenerate at 3-8 months after SBRT. The median NLV reduction at the maximal observed effect was 315 cm(3) (range, 125-600) or 19% (range, 13-33%). Among the several dosimetric parameters evaluated, the strongest linear correlation was noted for the NLV percentage receiving 30 Gy as a predictor of maximal NLV reduction (r(2) = 0.72). The histologic changes observed 2 and 8 months after SBRT demonstrated distinct zones of tissue injury consistent with localized veno-occlusive disease.Conclusion: The well-demarcated focal parenchymal changes after liver SBRT (demonstrated both radiographically and histologically) within the high-dose zone are consistent with a threshold dose-induced set of phenomena. In contrast, the more global effect of NLV reduction, which is roughly proportional to whole organ dose parameters, resembles more closely an effect determined from radiobiologically parallel architecture. These observations suggest that modeling of normal tissue effects after liver SBRT might require different governing equations for different classes of effects. (C) 2009 Elsevier Inc.