时空分割在中央型非小细胞肺癌立体定向放射治疗中的应用  

Application of spatiotemporal fractionation in stereotactic body radiation therapy for central non⁃small cell lung cancer

作　　者：陈诚[1] 沈九零 蒋大振 刘晖[1] CHEN Cheng;SHEN Jiuling;JIANG Dazhen;LIU Hui(Radiation Oncology Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院肿瘤放射治疗中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2024年第11期1329-1335,共7页Medical Journal of Wuhan University

基　　金：武汉大学中南医院科技创新培育基金药护技和管理专项基金(编号:CXPY2022056)。

摘　　要：目的:针对中央型肺癌大分割治疗的风险,研究时空分割在中央型非小细胞肺癌(NSCLC)立体定向放射治疗(SBRT)中的应用潜力。方法:选择20例体积较大的中央型NSCLC患者进行回顾性分析,为每位患者设计SBRT计划和时空分割计划,采用剂量体积直方图和剂量统计学参数等方法对两种治疗方案进行比较和评估。结果:时空分割在保证计划靶区(PTV)剂量与SBRT相当的前提下,显著降低了正常器官的物理剂量和生物等效剂量EQD_(10),其中肺、脊髓、心脏、气管和主支气管、食管的物理剂量分别降低了(11.16±0.37)%、(10.5±1.42)%、(16.6±0.49)%、(18.28±0.55)%、(18.58±1.34)%,EQD_(10)分别降低了(13.44±0.34)%、(10.03±1.44)%、(11.93±0.52)%、(22.26±0.52)%和(25.5±1.23)%。结论:与SBRT相比,时空分割能够在确保肿瘤控制的同时,更有效地减少周围正常组织的受损程度,提高了中央型NSCLC大分割治疗的安全性和有效性。Objective:To explore the application potential of spatiotemporal fractionation in stereotactic body radiation therapy(SBRT)for central non⁃small cell lung cancer(NSCLC)due to the risks associ⁃ated with large fractionations.Methods:Twenty patients with centrally located NSCLC and large tu⁃mor volumes were retrospectively analyzed.SBRT plans and spatiotemporal fractionation plans were designed for each patient,and the two treatment strategies were compared and evaluated using dose⁃volume histograms and dose statistics parameters.Results:Spatiotemporal fractionation significantly reduced the physical doses and equieffective dose EQD_(10) of normal organs while ensuring plan target volume(PTV)doses equivalent to SBRT.The physical doses of the lungs,spinal cord,heart,tra⁃chea/main bronchi,and esophagus were reduced by(11.16±0.37)%,(10.5±1.42)%,(16.6±0.49)%,(18.28±0.55)%,(18.58±1.34)%,respectively,and EQD_(10)values were reduced by(13.44±0.34)%,(10.03±1.44)%,(11.93±0.52)%,(22.26±0.52)%,and(25.5±1.23)%,respectively.Conclusion:Compared with SBRT,spatiotemporal fractionation can effectively reducethe damage to surrounding normal tissues while ensuring tumor control,thus improving the safety andeffectiveness of large fractionation treatment for centrally located NSCLC.

关 键 词：中央型非小细胞肺癌 时空分割 立体定向放射治疗 物理剂量 生物等效剂量 剂量体积直方图 安全性 

分 类 号：R730.55[医药卫生—肿瘤]