The potential of integrating stereotactic ablative radiotherapy techniques with hyperfractionation for lung cancer.

IF 2.3 3区 医学 Q3 ONCOLOGY
Thoracic Cancer Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI:10.1111/1759-7714.15335
Chi-Chuan Chiou, Yuan-Hung Wu, Pin-I Huang, Keng-Li Lan, Yi-Wei Chen, Yu-Mei Kang, Lin-Shan Chou, Yu-Wen Hu
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引用次数: 0

Abstract

Background: Limited literature exists on the feasibility and effectiveness of integrating stereotactic ablative radiotherapy (SABR) techniques with hyperfractionated regimens for patients with lung cancer. This study aims to assess whether the SABR technique with hyperfractionation can potentially reduce lung toxicity.

Methods: We utilized the linear-quadratic model to find the optimal fraction to maximize the tumor biological equivalent dose (BED) to normal-tissue BED ratio. Validation was performed by comparing the SABR plans with 50 Gy/5 fractions and hyperfractionationed plans with 88.8 Gy/74 fractions with the same tumor BED and planning criteria for 10 patients with early-stage lung cancer. Mean lung BED, Lyman-Kutcher-Burman (LKB) normal tissue complication probability (NTCP), critical volume (CV) criteria (volume below BED of 22.92 and 25.65 Gy, and mean BED for lowest 1000 and 1500 cc) and the percentage of the lung receiving 20Gy or more (V20) were compared using the Wilcoxon signed-rank test.

Results: The transition point occurs when the tumor-to-normal tissue ratio (TNR) of the physical dose equals the TNR of α/β in the BED dose-volume histogram of the lung. Compared with the hypofractionated regimen, the hyperfractionated regimen is superior in the dose range above but inferior below the transition point. The hyperfractionated regimen showed a lower mean lung BED (6.40 Gy vs. 7.73 Gy) and NTCP (3.50% vs. 4.21%), with inferior results concerning CV criteria and higher V20 (7.37% vs. 7.03%) in comparison with the hypofractionated regimen (p < 0.01 for all).

Conclusions: The hyperfractionated regimen has an advantage in the high-dose region of the lung but a disadvantage in the low-dose region. Further research is needed to determine the superiority between hypo- and hyperfractionation.

将立体定向烧蚀放疗技术与超分割技术相结合治疗肺癌的潜力。
背景:有关肺癌患者将立体定向消融放疗(SABR)技术与超分割方案相结合的可行性和有效性的文献有限。本研究旨在评估立体定向消融放疗技术与超分割治疗是否有可能降低肺部毒性:方法:我们利用线性二次模型来寻找最佳分次,以最大限度地提高肿瘤生物等效剂量(BED)与正常组织 BED 的比值。在相同肿瘤生物等效剂量和计划标准下,对10名早期肺癌患者进行了验证,比较了50 Gy/5次分次的SABR计划和88.8 Gy/74次分次的超分割计划。使用 Wilcoxon 符号秩检验比较了平均肺 BED、Lyman-Kutcher-Burman(LKB)正常组织并发症概率(NTCP)、临界容积(CV)标准(低于 BED 22.92 和 25.65 Gy 的容积,以及最低 1000 和 1500 cc 的平均 BED)和接受 20Gy 或更多的肺的百分比(V20):当物理剂量的肿瘤与正常组织比值(TNR)等于肺部BED剂量-体积直方图中α/β的TNR时,即为过渡点。与低分次方案相比,超分次方案在过渡点以上的剂量范围内效果更好,但在过渡点以下的剂量范围内效果较差。与低分量方案相比,超分量方案的平均肺BED(6.40 Gy 对 7.73 Gy)和NTCP(3.50% 对 4.21%)较低,CV标准方面的结果较差,V20(7.37% 对 7.03%)较高(P 结论:超分量方案的平均肺BED(6.40 Gy 对 7.73 Gy)和NTCP(3.50% 对 4.21%)较低,CV标准方面的结果较差,V20(7.37% 对 7.03%)较高:超分剂量方案在肺部高剂量区域具有优势,但在低剂量区域存在劣势。要确定低剂量和高剂量方案之间的优劣,还需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Thoracic Cancer
Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM
CiteScore
5.20
自引率
3.40%
发文量
439
审稿时长
2 months
期刊介绍: Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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