Diaphragm and lung dose in liver high-dose-rate interstitial brachytherapy: A dosimetry and toxicity report.

IF 1.1 4区医学 Q4 ONCOLOGY

Journal of Contemporary Brachytherapy Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI:10.5114/jcb.2025.148297

Keerthaanaa Yogabalan, Gokula Kumar Appalanaido, Ch'ng Ewe Seng, Jasmin Bin Jalil, Jayapramila Jayamani, Nor Hafizah Ishak, Nursyatina Abdul Raof, Reduan Bin Abdullah, Ahamed Badusha Mohamed Yoosuf, Muhamad Zabidi Ahmad, Bazli Md Yusoff, Mohd Zahri Abdul Aziz

{"title":"Diaphragm and lung dose in liver high-dose-rate interstitial brachytherapy: A dosimetry and toxicity report.","authors":"Keerthaanaa Yogabalan, Gokula Kumar Appalanaido, Ch'ng Ewe Seng, Jasmin Bin Jalil, Jayapramila Jayamani, Nor Hafizah Ishak, Nursyatina Abdul Raof, Reduan Bin Abdullah, Ahamed Badusha Mohamed Yoosuf, Muhamad Zabidi Ahmad, Bazli Md Yusoff, Mohd Zahri Abdul Aziz","doi":"10.5114/jcb.2025.148297","DOIUrl":null,"url":null,"abstract":"Purpose: The aim of this study was to retrospectively analyze and report on dose-volume and clinical toxicity of liver high-dose-rate interstitial brachytherapy (HDR-IBT) used in diaphragm and lung tissue.Material and methods: Computed tomography (CT)-based liver HDR-IBT using Oncentra Brachy treatment planning system (TPS) plans of patients with malignant liver tumor (MLT) from September 2018 to June 2023 were reviewed to identify patients, whose diaphragm and lung tissue were within 100% prescription isodose. These organs at risk (OARs) were contoured in axial CT slices. Maximum point dose (Dmax), dose to 0.2 cc, 0.5 cc, 1 cc (D0.2cc, D0.5cc, D1cc), and volume receiving 30 Gy and 50 Gy (V30Gy and V50Gy) were analyzed. Toxicity data of these patients were retrieved from hospital electronic records.Results: The analysis included 27 patients with 43 and 36 MLTs, whose 100% prescription isodose of liver HDR-IBT plan was within diaphragm and lung tissue. Median prescription dose was 25 Gy (range, 15-25 Gy) in single-fraction. Median Dmax, D0.2cc, D0.5cc, and D1cc of the diaphragm were 302 Gy (range, 54-396 Gy), 68 Gy (range, 38-234 Gy), 48 Gy (range, 32-128 Gy), and 35 Gy (range, 27-88 Gy), while for the lung, 90 Gy (range, 39-295 Gy), 55 Gy (range, 32-207 Gy), 44 Gy (range, 29-117 Gy), and 34 Gy (range, 25-79 Gy), respectively. Median V30Gy and V50Gy for the diaphragm were 1.1 cc (range, 0-5.8 cc) and 0.2 cc (range, 0-2.5 cc), while for the lung, 0.8 cc (range, 0-10.1 cc) and 0.1 cc (range, 0-2.3 cc), receptively. Two patients with repeated HDR-IBT sessions received cumulative Dmax diaphragm of 698 Gy and 792 Gy. At median follow-up of 23 months, no patient reported any suspicious symptom of radiation-induced diaphragm or lung injury.Conclusions: This is the first publication reporting diaphragm and lung tissue dose-volume and clinical toxicity in liver HDR-IBT. Small volume of diaphragm and lung tissue tolerated extreme high radiation doses [5 times of stereotactic body radiotherapy (SBRT) range in single fraction] without clinically significant toxicity. A standardized reporting for diaphragm and lung dose volume is needed for future liver HDR-IBT studies. The results of the current study can be employed in future for expanded indication of brachytherapy, such as CT-guided trans-thoracic lung brachytherapy.","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 1","pages":"28-32"},"PeriodicalIF":1.1000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966225/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Contemporary Brachytherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5114/jcb.2025.148297","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/28 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: The aim of this study was to retrospectively analyze and report on dose-volume and clinical toxicity of liver high-dose-rate interstitial brachytherapy (HDR-IBT) used in diaphragm and lung tissue.

Material and methods: Computed tomography (CT)-based liver HDR-IBT using Oncentra Brachy treatment planning system (TPS) plans of patients with malignant liver tumor (MLT) from September 2018 to June 2023 were reviewed to identify patients, whose diaphragm and lung tissue were within 100% prescription isodose. These organs at risk (OARs) were contoured in axial CT slices. Maximum point dose (D_max), dose to 0.2 cc, 0.5 cc, 1 cc (D_0.2cc, D_0.5cc, D_1cc), and volume receiving 30 Gy and 50 Gy (V_30Gy and V_50Gy) were analyzed. Toxicity data of these patients were retrieved from hospital electronic records.

Results: The analysis included 27 patients with 43 and 36 MLTs, whose 100% prescription isodose of liver HDR-IBT plan was within diaphragm and lung tissue. Median prescription dose was 25 Gy (range, 15-25 Gy) in single-fraction. Median D_max, D_0.2cc, D_0.5cc, and D_1cc of the diaphragm were 302 Gy (range, 54-396 Gy), 68 Gy (range, 38-234 Gy), 48 Gy (range, 32-128 Gy), and 35 Gy (range, 27-88 Gy), while for the lung, 90 Gy (range, 39-295 Gy), 55 Gy (range, 32-207 Gy), 44 Gy (range, 29-117 Gy), and 34 Gy (range, 25-79 Gy), respectively. Median V_30Gy and V_50Gy for the diaphragm were 1.1 cc (range, 0-5.8 cc) and 0.2 cc (range, 0-2.5 cc), while for the lung, 0.8 cc (range, 0-10.1 cc) and 0.1 cc (range, 0-2.3 cc), receptively. Two patients with repeated HDR-IBT sessions received cumulative D_max diaphragm of 698 Gy and 792 Gy. At median follow-up of 23 months, no patient reported any suspicious symptom of radiation-induced diaphragm or lung injury.

Conclusions: This is the first publication reporting diaphragm and lung tissue dose-volume and clinical toxicity in liver HDR-IBT. Small volume of diaphragm and lung tissue tolerated extreme high radiation doses [5 times of stereotactic body radiotherapy (SBRT) range in single fraction] without clinically significant toxicity. A standardized reporting for diaphragm and lung dose volume is needed for future liver HDR-IBT studies. The results of the current study can be employed in future for expanded indication of brachytherapy, such as CT-guided trans-thoracic lung brachytherapy.

查看原文本刊更多论文

肝高剂量率间质近距离放射治疗中的膈肺剂量：剂量学和毒性报告。

目的：本研究旨在回顾性分析和报告在膈肌和肺组织中使用的肝脏高剂量率间质近距离放射治疗（HDR-IBT）的剂量-体积和临床毒性：对2018年9月至2023年6月期间恶性肝肿瘤（MLT）患者使用Oncentra Brachy治疗计划系统（TPS）的基于计算机断层扫描（CT）的肝脏HDR-IBT计划进行审查，以确定膈肌和肺组织在100%处方等剂量范围内的患者。这些风险器官（OAR）在轴向 CT 切片中进行了轮廓分析。分析了最大点剂量（Dmax）、0.2cc、0.5cc、1cc 剂量（D0.2cc、D0.5cc、D1cc）以及接受 30 Gy 和 50 Gy 的体积（V30Gy 和 V50Gy）。这些患者的毒性数据均来自医院电子病历：分析对象包括27名患者，分别接受了43次和36次MLT，其肝脏HDR-IBT计划的100%处方等剂量在膈肌和肺组织内。单次分次处方剂量中位数为25 Gy（范围为15-25 Gy）。膈肌的中位 Dmax、D0.2cc、D0.5cc 和 D1cc 分别为 302 Gy（范围，54-396 Gy）、68 Gy（范围，38-234 Gy）、48 Gy（范围，32-128 Gy）和 35 Gy（范围，27-88 Gy），而肺的中位 Dmax、D0.2cc、D0.5cc 和 D1cc 分别为 90 Gy（范围，39-295 Gy）、55 Gy（范围，32-207 Gy）、44 Gy（范围，29-117 Gy）和 34 Gy（范围，25-79 Gy）。膈肌的中位 V30Gy 和 V50Gy 分别为 1.1 cc（范围 0-5.8 cc）和 0.2 cc（范围 0-2.5 cc），而肺的中位 V30Gy 和 V50Gy 分别为 0.8 cc（范围 0-10.1 cc）和 0.1 cc（范围 0-2.3 cc）。两名重复接受 HDR-IBT 治疗的患者分别接受了 698 Gy 和 792 Gy 的累积最大膈肌剂量。中位随访时间为 23 个月，没有患者报告任何辐射引起的膈肌或肺损伤的可疑症状：这是第一篇报道肝脏 HDR-IBT 中横膈膜和肺组织剂量-体积及临床毒性的文章。小体积的膈肌和肺组织可耐受极高的辐射剂量（单次分量为立体定向体放射治疗（SBRT）范围的5倍），且无明显的临床毒性。未来的肝脏 HDR-IBT 研究需要对膈和肺的剂量体积进行标准化报告。本研究的结果可用于今后扩大近距离放射治疗的适应症，如CT引导下的经胸肺近距离放射治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.40

自引率

14.30%

发文量

审稿时长

16 weeks

期刊介绍： The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.