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Clinical studies on the simultaneous integrated boost method using intensity modulated radiotherapy (IMRT)

调强放射治疗（IMRT）同步整合增强法的临床研究

基本信息

批准号：
17591300
负责人：
NISHIMURA Yasumasa
金额：
$ 2.43万
依托单位：
Kinki University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

项目摘要

We have finished a pilot study on the treatment of malignant gliomas with intensity modulated radiotherapy (IMRT) using a simultaneous integrated boost (SIB) method. Our IMRT regimen delivered 70 Gy/28 fractions (fr)/daily 2.5 Gy to the gross tumor volume (GTV) with a 0.5-cm margin defined as the planning target volume annulus (PTV-G) and 56 Gy/28 fr/daily 2.0 Gy to the surrounding edema defined as the planning target volume annulus (PTV-a). Unfortunately, all the 13 patients experienced tumor recurrence. The 1-year and 2-year overall survival rate for all the patients was 77 and 31%, respectively. In conclusion, our IMRT regimen did not prevent tumor progression. However, the ability of IMRT to deliver highly conformative doses to two contiguous targets, GTV and the surrounding edema, justifies its application to malignant gliomas.Clinical results of 74 patients with pharyngeal cancer treated with IMRT. The 5-year survival rate for the 27 patients with nasopharyngeal cancer was as goo … More d as 75%. The 3-year survival rates for oropharyngeal and hypopharyngeal cancers were 87% and 48%, respectively. Only 1/4 of the patients treated by IMRT complained moderate xerostomia (grade 2) one year after treatment. For early oropharyngeal cancer with T1,2NOMO disease, treatment planning Of SIB method was established, and applied for three patients. Our IMRT regimen delivered 66 Gy/30 fr/daily 2.2 Gy to the GTV with a 0.5-cm margin and 54 Gy/30 fr /daily 1.8 Gy to the prophylactic lymph node areas.Positron emission tomography (PET) is useful for radiation therapy treatment planning. However, the size of PET delineation changes significantly dependent on its threshold value, and the PET image affects the target delineation clinically. To determine an appropriate threshold value for delineation of the target in PET images, static and moving phantom studies were performed. When a threshold value of 35% of the maximum 18FDG activity was adopted, PET-images were almost the same for static and moving phantom spheres of 22〜37mm in the axial plane. In moving phantom experiments with a periodic motion of 4 seconds, the maximum 18FDG activity of spheres dropped significantly dependent on moving distance. In addition, PET images have the potential to provide an individualized internal target volume (ITV). Less

我们已经完成了一个试点研究的恶性胶质瘤的调强放射治疗（IMRT）使用同步积分升压（SIB）的方法。我们的调强放射治疗方案向大体肿瘤体积（GTV）输送70戈伊/28次（fr）/每日2.5戈伊，边缘为0.5 cm，定义为计划靶体积环（PTV-G），向周围水肿输送56戈伊/28 fr/每日2.0戈伊，定义为计划靶体积环（PTV-a）。不幸的是，所有13例患者都出现了肿瘤复发。所有患者的1年和2年总生存率分别为77%和31%。总之，我们的调强放射治疗方案不能阻止肿瘤进展。然而，调强放射治疗的能力，提供高适形剂量的两个相邻的目标，GTV和周围的水肿，证明其应用于恶性胶质瘤。74例咽癌患者的IMRT治疗的临床结果。27例鼻咽癌患者的5年生存率为100%， ...更多信息 D为75%。口咽癌和下咽癌的3年生存率分别为87%和48%。接受IMRT治疗的患者中只有1/4在治疗后1年出现中度口干（2级）。对T1，2NOMO期早期口咽癌，采用SIB法制定治疗计划，并应用于3例患者。我们的调强放射治疗方案是66戈伊/30 fr/daily 2.2戈伊至GTV，边缘0.5 cm，54戈伊/30 fr /daily 1.8戈伊至预防性淋巴结区域。然而，PET轮廓的大小显著地依赖于其阈值而变化，并且PET图像影响临床上的目标轮廓。为了确定PET图像中描绘目标的适当阈值，进行了静态和移动体模研究。当采用最大18FDG活性的35%的阈值时，PET图像对于轴向平面上22 × 37 mm的静态和移动体模球体几乎相同。在4秒周期运动的移动体模实验中，球体的最大18FDG活性随移动距离显著下降。此外，PET图像具有提供个体化内部靶体积（ITV）的潜力。少