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非小细胞肺癌肿瘤总体积内的剂量平均线性能量传递影响碳离子放疗的局部控制。

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2024-10-14 DOI:10.1016/j.radonc.2024.110584

Guangsheng Li , Ningyi Ma , Weiwei Wang , Jian Chen , Jingfang Mao , Guoliang Jiang , Kailiang Wu

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引用次数: 0

摘要

背景和目的：高线性能量转移（LET）辐射具有更强的肿瘤杀伤效果。然而，在局部晚期非小细胞肺癌（LA-NSCLC）的碳离子放射治疗（CIRT）中，LET与疗效之间的相关性目前尚不清楚。本研究旨在探讨接受 CIRT 治疗的 LA-NSCLC 肿瘤内剂量平均 LET（LETd）分布与局部复发之间的关系：对2018年至2022年连续接受CIRT治疗的62例LA-NSCLC患者进行了分析。根据其治疗方案计算LETd分布，并研究局部复发与LETd、相对生物有效性（RBE）加权剂量（DRBE）和临床因素之间的相关性。在此基础上进行了接收者操作特征曲线（ROC）、对数秩检验和 Cox 回归分析：结果：16 例患者被定义为局部复发。24个月的总生存率（OS）和局部控制率（LC）分别为76.9%和73.2%。局部复发组肿瘤内部总体积（iGTV）的平均LETd为48.7 keV/µm，明显低于局部控制组53.2 keV/µm的平均LETd（p = 0.016）。局部复发组和局部对照组的 DRBE 无明显差异。ROC 曲线分析表明，iGTV 中至少有 88% 的体积接受了 40 keV/µm（V40keV/μm），是预测局部复发的最佳阈值（曲线下面积 (AUC) = 0.7636）。对数秩检验和 Cox 回归分析显示，覆盖 iGTV 98% 体积的 LETd 值（LETd98%）是 LC 的重要风险因素（p = 0.020）：我们的研究揭示了LA-NSCLC患者LETd分布与局部复发之间的关系。这些发现表明，较低的 LETd 可能会增加局部复发的概率。我们建议在肺癌 CIRT 中常规评估 iGTV 中的 LETd 分布。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Dose-averaged linear energy transfer within the gross tumor volume of non-small-cell lung cancer affects the local control in carbon-ion radiotherapy

Background and purpose

High linear energy transfer (LET) radiation exhibits stronger tumor-killing effect. However, the correlation between LET and the therapeutic efficacy in Carbon-ion radiotherapy (CIRT) for locally advanced non-small-cell lung cancer (LA-NSCLC) is currently not clear. This study aimed to investigate the relationship between the dose-averaged LET (

{LET}_{d}

) distribution within tumor and local recurrence for LA-NSCLC treated with CIRT.

Methods and materials

An analysis of 62 consecutive patients with LA-NSCLC who underwent CIRT from 2018 to 2022 was conducted. The

{LET}_{d}

distribution was calculated based on their treated plans, and the correlation between local recurrence and

{LET}_{d}

, relative biological effectiveness (RBE)-weighted doses (

D_{RBE}

) and clinical factors was investigated. Receiver operating characteristic (ROC) curve, log-rank test, and Cox regression analysis were performed based on that.

Results

16 patients were defined as local recurrence. Overall survival (OS) and local control (LC) at 24 months were 76.9 % and 73.2 %, respectively. The mean

{LET}_{d}

in internal gross tumor volume (iGTV) in the local recurrence group was 48.7 keV/µm, significantly lower than the mean

{LET}_{d}

of 53.2 keV/µm in the local control group (p = 0.016). No significant difference was observed in

D_{RBE}

between the local recurrence and local control groups. ROC curve analysis indicated that a percentage of 88 % of volume in iGTV receiving at least 40 keV/µm (

V_{40 k e V / μ m}

) is the optimal threshold for predicting local recurrence (Area under curve (AUC) = 0.7636). The log-rank test and Cox regression analysis revealed that the

{LET}_{d}

value covering 98 % volume of iGTV (

{LET}_{d} 98 %

) was a significant risk factor for LC (p = 0.020).

Conclusions

Our study revealed an association between

{LET}_{d}

distribution and local recurrence in patients with LA-NSCLC. These findings suggest that lower

{LET}_{d}

may increase the probability of local recurrence. We suggest that

{LET}_{d}

distribution within iGTV should be routinely assessed in CIRT for lung cancer.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.