Artificial spacing of risk organs from radiation target by liquid injection into peritoneal cavity

通过将液体注入腹膜腔来人工间隔危险器官与辐射靶区

• 批准号: 13670908
• 负责人: NEMOTO Kenji
• 金额: $ 1.41万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13670908/
• 关键词: Ascitis; DVH; Radiation therapy; Fluid injection; SRT; スペーサー; 腹水; 術中照射; バルーン; 重要臓器; 治療計画; 定位照射; カテーテル; 線量分布; 内視鏡的手技

Using 10 pair of CT scan data set, one with ascitis and another without ascitis, the influence of ascitis on dose volume histogram of radiation therapy. Sham targets were set in liver, para-aortic lymph nodes, iliac lymph nodes, uterus, and prostate (2-4cm in diameter) and radiotherapy planning was done for each target using four box-field method. The margin from CTV was 1cm in all cases. As a result, 40 pair of radiotherapy plan (liver, para-aortic lymph node, iliac lymph node, and uterus or prostate) was made for each sham target and DVH of these plans were compared and analyzed with radiotherapy computer. Risk organ was defined as intestine and abdominal wall or diaphragm for upper abdominal tumor. For pelvic tumor, risk organs was defined as rectum and urinary bladder.In all patients, the existence and volume of ascitis did not significantly influence dose or intestine, rectum, urinary bladder. However, in case of liver surface tumor radiation therapy, ascitis significantly reduce the dose for diaphragm and abdominal wall. In case of radiation therapy of liver tumor that is adjacent to intestine (under part of liver surface), ascitis was also expected to reduce the intestinal radiation dose.In conclusion, liquid, injection into peritoneal space before radiation therapy for surface liver tumor seems to reduce toxicity. However, daily CT checking and positioning of patients is essential. Subtable for patients fixation and special stretcher to transport patients from CT table to linac table is very useful for this pourpose.

利用10对CT扫描数据集，一组有腹水，另一组无腹水，观察腹水对放射治疗剂量体积直方图的影响。在肝脏、主动脉旁淋巴结、髂淋巴结、子宫和前列腺(直径2-4cm)中设置假靶点，并采用四箱场法对每个靶点制定放疗计划。在所有情况下，CTV 的边缘均为 1cm。结果，为每个假靶点制定了40对放疗计划（肝脏、主动脉旁淋巴结、髂淋巴结、子宫或前列腺），并用放疗计算机对这些计划的DVH进行了比较和分析。危险器官被定义为上腹部肿瘤的肠和腹壁或膈肌。对于盆腔肿瘤，危险器官定义为直肠和膀胱。在所有患者中，腹水的存在和体积对剂量或肠、直肠、膀胱没有显着影响。但肝表面肿瘤放疗时，腹水引起膈肌和腹壁的剂量明显减少。在对邻近肠道（部分肝表面以下）的肝肿瘤进行放射治疗时，腹水也有望减少肠道辐射剂量。 总之，在对表面肝肿瘤进行放射治疗之前将液体注射到腹膜间隙似乎可以减少毒性。然而，日常 CT 检查和患者定位至关重要。用于患者固定的子工作台和用于将患者从 CT 台转移到直线加速器台的特殊担架对此非常有用。

项目成果

Nemoto K, Matsushita H, Ogawa Y, Takeda K, Takahashi C, Britton KR, Takai Y, Miyazaki S, Miyata T, Yamada S.: "Radiation therapy combined with cis-diammine-glycolatoplatinum (Nedaplatin) and 5-fluorouracil for untreated and recurrent esophageal cancer"Am

Nemoto K、Matsushita H、Okawa Y、Takeda K、Takahashi C、Britton KR、Takai Y、Miyazaki S、Miyata T、Yamada S.：“放射治疗联合顺式-二氨-甘醇铂（Nedaplatin）和 5-氟尿嘧啶治疗未经治疗的患者

Nemoto K.: "Radiation therapy for loco regionally recurrent esophageal cancer after surgery"Radiother Oncol. 61. 165-168 (2001)

Nemoto K.：“手术后局部区域复发食管癌的放射治疗”Radiother Oncol。

Kenji Nemoto: "Intraoperative radiation therapy (IORT) for previously untreated malignant gliomas"BMC Cancer. 2巻. 1-4 (2002)

Kenji Nemoto：“术中放射治疗（IORT）用于先前未治疗的恶性神经胶质瘤”BMC Cancer Vol. 2. 1-4 (2002)

根本建二: "食道表在癌の治療展望-放射線治療を中心に-"日本医学放射線学会雑誌. 62巻. 801-807 (2002)

Kenji Nemoto：“浅表性食管癌的治疗前景 - 聚焦放射治疗”日本医学放射学会杂志第 62 卷 801-807（2002 年）。

Nemoto K.: "Apilot study of radiation therapy combined with daily low-dose cisplatin for esophageal canser"Oncol Rep. 8. 785-789 (2001)

Nemoto K.：“放射治疗联合每日低剂量顺铂治疗食管癌的试点研究”Oncol Rep. 8. 785-789 (2001)