Local control and recurrence of stage I non-small cell lung cancer after carbon ion radiotherapy
Local control and recurrence of stage I non-small cell lung cancer after carbon ion radiotherapy
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DOI：
10.1016/j.radonc.2004.02.007
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发表时间：
2004-05-01
影响因子：
5.7
通讯作者：
Tsujii, H
中科院分区：
文献类型：
--
作者：
Koto, M;Miyamoto, T;Tsujii, H
背景和目的：为了正确评估 81 例 I 期非小细胞肺癌患者 82 个病灶的碳离子束剂量递增与局部控制之间的关系，我们通过将剂量分布与 CT 图像进行比较，确定了现场复发的发生率。 患者和方法： 47 名患者（48 个病灶）6 周内 18 次剂量和 34 名患者 3 周内 9 次剂量采用碳剂量递增方法分别从 59.4 到 95.4 戈瑞当量（GyE）增加 10%，从 68.4 到 79.2 GyE 增加 5%。放射靶标由原发肿瘤组成。治疗后对局部复发患者进行系统的图像分析，重点关注原发病灶的增强薄层CT图像。通过将剂量分布叠加在计划 CT 图像上并标记解剖学上识别的复发位点，可以建立剂量分布与初始复发位点之间的关系，并根据复发位点的差异对复发模式进行分类。 结果：在总共 82 个病灶中，有 19 个（23.2%）发现局部复发。可以区分三种复发模式：模式 I 代表边缘复发，模式 2a 和 2b 都是现场复发的实例。在模式 1 中，肿瘤上边缘区域发生四次复发。在模式 2a 中，从肿瘤中心发生 13 次复发。在模式2b中，两次复发发生在肿瘤近中心处。结论：对于排除4个边缘复发病灶（模式1）后的15个场内复发病灶（模式2a和2b），我们已经确定局部对照表现出剂量依赖性。在此基础上，我们确定了最佳治疗剂量。 (C) 2004 Elsevier Ireland Ltd. 保留所有权利。
Background and purpose: For a proper evaluation of the relationship between carbon ion beam dose escalation and local control in the 81 patients with 82 lesions of stage I non-small cell lung cancer, we have identified the incidence of in-field recurrence by collating the dose distribution with the CT images.Patients and methods: Eighteen fractions over 6 weeks for 47 patients (48 lesions) and nine fractions over 3 weeks for 34 patients were applied in the carbon dose escalation method from 59.4 to 95.4 gray equivalents (GyE) by a 10% increment and from 68.4 to 79.2 GyE by a 5% increment, respectively. The radiation target consisted of primary tumor. Image analysis of the patients with local recurrence was systematically performed after the treatment by focusing attention on the enhanced thin slice CT images of the primary lesion. By superimposing the dose distribution on the planning CT image and marking the anatomically identified loci of recurrence, it was possible to establish the relationship between the dose distribution and the incipient loci of recurrence and to classify the recurrence patterns from the differences in the recurrence loci.Results: Local recurrence was found in 19 (23.2%) out of a total of 82 lesions. It is possible to distinguish between three recurrence patterns: Pattern I representing marginal recurrence and patterns 2a and 2b, which are both instances of in-field recurrence. In pattern 1, four recurrences take place from a region on the upper tumor margin. In pattern 2a, 13 recurrences take place from the center of the tumor. In pattern 2b, two recurrences take place from the near-center of the tumor.Conclusions: For the 15 in-field recurrence lesions (patterns 2a and 2b) after excluding the four marginal recurrence lesions (patterns 1), we have established that the local control shows dose-dependence. Based on this, we have determined the optimal therapeutic dose. (C) 2004 Elsevier Ireland Ltd. All rights reserved.