Application of real-time tumor-tracking and gated radiotherapy system for unresectable pancreatic cancer
Application of real-time tumor-tracking and gated radiotherapy system for unresectable pancreatic cancer
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DOI：
10.3349/ymj.2004.45.4.584
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发表时间：
2004-08-31
影响因子：
2.4
通讯作者：
Miyasaka, K
中科院分区：
文献类型：
--
作者：
Ahn, YC;Shimizuz, S;Miyasaka, K
本文报告了我们使用实时肿瘤跟踪和门控放疗（RTRT）系统治疗不能手术的胰腺癌的经验。3例不可切除的胰腺癌患者在术中、开刀活检时接受电子束放射治疗，术后采用RTRT系统，在胰腺内植入直径2.0 mm的金球进行外束放射治疗。总BED （α / β =10）相当于以2.0 Gy/分数递送60 Gy的剂量，而实际剂量计划则是个体化的。根据RTRT过程中三维标记物的位置分析胰腺的运动。对副作用和肿瘤反应进行了评价。在RTRT过程中，标记物在x（从左到右）、y（从颅到尾）和z（从背到腹）方向的平均移动分别为3.0 mm （1.7 ~ 5.2 mm）、5.2 mm （3.5 ~ 6.8 mm）和3.5 mm （2.7 ~ 5.1 mm）。在术后放疗过程中及之后，未发现RTOG 11级及以上的急性副作用。治疗3个月后CT扫描评估的客观肿瘤反应为2例部分反应，1例无反应。RTRT技术减少了治疗计划的裕度和目标定位可能出现的误差，并能够分析植入胰腺的内部标记物的三维运动。
Herein is reported our experience of radiation therapy using a real-time tumor-tracking and gated radiotherapy (RTRT) system for inoperable pancreatic cancer. Three unresectable pancreatic cancer patients were treated with intraoperative electron beam radiation therapy, at the time of open biopsy, and postoperative external beam radiation therapy using an RTRT system with a 2.0 mm diameter gold ball implanted into the pancreas. The total BED's(alpha/beta=10) was intended to be equivalent to that of delivering 60 Gy by 2.0 Gy/fraction, while the actual dose schedules were individualized. The movement of the pancreas was analyzed based on the 3-dimensional marker positions during the RTRT. The side effects and tumor responses were evaluated. During the RTRT course, the average movement of markers in the x (left to right), y (cranial to caudal) and z (dorsal to ventral) directions were 3.0 mm (1.7- 5.2 mm), 5.2 mm (3.5 - 6.8 mm) and 3.5 mm (2.7 - 5.1 mm), respectively. During and after the course of postoperative radiation therapy, no acute side effects of RTOG grade 11 or higher were detected. The objective tumor responses, as evaluated by CT scans 3 months after the treatment, were 2 partial responses and no response in one patient. Using the RTRT technique the margin of treatment planning and the possible errors in target localization were reduced, and the 3-dimensional movement of the internal marker implanted in the pancreas was able to be analyzed.