基于共面dca的低分割立体定向放疗治疗非小细胞肺癌极小脑转移:治疗方案与共面VMAT的比较及初步临床结果

IF 2 4区 医学 Q3 ENGINEERING, BIOMEDICAL
Shipai Zhu, An Li, Jia Liu, Qin Deng, Qingfang Li, Jialu Lai, Lin Zhou
{"title":"基于共面dca的低分割立体定向放疗治疗非小细胞肺癌极小脑转移:治疗方案与共面VMAT的比较及初步临床结果","authors":"Shipai Zhu, An Li, Jia Liu, Qin Deng, Qingfang Li, Jialu Lai, Lin Zhou","doi":"10.1007/s13246-025-01640-z","DOIUrl":null,"url":null,"abstract":"<p><p>To assess the clinical outcome of single-arc coplanar dynamic conformal arc (C-DCA) in three-fraction hypofractionated stereotactic radiotherapy (3F-HSRT) for single very small brain metastasis (BM; gross tumor volume [GTV] ≤ 1 cm<sup>3</sup>) from non-small cell lung cancer (NSCLC) and to compare treatment planning with single-arc coplanar volumetric modulated arc therapy (C-VMAT). From December 2019 to May 2023, twenty NSCLC patients with single BM treated with 3F-HSRT (24-39 Gy/3f) using C-DCA were enrolled in this study. Each plan was replanned using C-VMAT, and relevant planning indices were compared. Clinical outcome was evaluated following C-DCA treatment. C-VMAT yielded a higher homogeneity index (1.41 vs. 1.16, p < 0.001) and GTV D<sub>98%</sub> (38.10 Gy vs. 32.72 Gy, p = 0.008), with slightly smaller normal brain tissue (NBT) V<sub>23Gy</sub>, and V<sub>21Gy</sub>. However, C-DCA offered 31.37% lower monitor units (p = 0.008) and 36.55% shorter beam on time (p = 0.007) while achieving a significantly higher gamma passing rate for the 2%/1 mm criterion (p = 0.001). As of October 2023, the median follow-up time was 9.2 months. The intracranial disease control rate was 70%, with a median intracranial progression-free survival of 11.4 (95% CI 4.5-18.3) months and a 1-year intracranial control rate of 45.4%. The intracranial local disease control rate was 95%. Only two irradiated lesions progressed at the end of follow-up. The cerebral radiation necrosis rate of all patients was 5%. For small BM, C-DCA provided nearly equivalent target coverage and NBT sparing to the C-VMAT while maintaining higher delivery efficiency and accuracy. C-DCA HSRT also provided good local control and limited toxicity.</p>","PeriodicalId":48490,"journal":{"name":"Physical and Engineering Sciences in Medicine","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Coplanar DCA-based hypofractionated stereotactic radiotherapy for very small brain metastasis from non-small cell lung cancer: treatment planning comparison with coplanar VMAT and preliminary clinical outcome.\",\"authors\":\"Shipai Zhu, An Li, Jia Liu, Qin Deng, Qingfang Li, Jialu Lai, Lin Zhou\",\"doi\":\"10.1007/s13246-025-01640-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To assess the clinical outcome of single-arc coplanar dynamic conformal arc (C-DCA) in three-fraction hypofractionated stereotactic radiotherapy (3F-HSRT) for single very small brain metastasis (BM; gross tumor volume [GTV] ≤ 1 cm<sup>3</sup>) from non-small cell lung cancer (NSCLC) and to compare treatment planning with single-arc coplanar volumetric modulated arc therapy (C-VMAT). From December 2019 to May 2023, twenty NSCLC patients with single BM treated with 3F-HSRT (24-39 Gy/3f) using C-DCA were enrolled in this study. Each plan was replanned using C-VMAT, and relevant planning indices were compared. Clinical outcome was evaluated following C-DCA treatment. C-VMAT yielded a higher homogeneity index (1.41 vs. 1.16, p < 0.001) and GTV D<sub>98%</sub> (38.10 Gy vs. 32.72 Gy, p = 0.008), with slightly smaller normal brain tissue (NBT) V<sub>23Gy</sub>, and V<sub>21Gy</sub>. However, C-DCA offered 31.37% lower monitor units (p = 0.008) and 36.55% shorter beam on time (p = 0.007) while achieving a significantly higher gamma passing rate for the 2%/1 mm criterion (p = 0.001). As of October 2023, the median follow-up time was 9.2 months. The intracranial disease control rate was 70%, with a median intracranial progression-free survival of 11.4 (95% CI 4.5-18.3) months and a 1-year intracranial control rate of 45.4%. The intracranial local disease control rate was 95%. Only two irradiated lesions progressed at the end of follow-up. The cerebral radiation necrosis rate of all patients was 5%. For small BM, C-DCA provided nearly equivalent target coverage and NBT sparing to the C-VMAT while maintaining higher delivery efficiency and accuracy. C-DCA HSRT also provided good local control and limited toxicity.</p>\",\"PeriodicalId\":48490,\"journal\":{\"name\":\"Physical and Engineering Sciences in Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physical and Engineering Sciences in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13246-025-01640-z\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physical and Engineering Sciences in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13246-025-01640-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0

摘要

评价单弧共面动态适形电弧(C-DCA)在非小细胞肺癌(NSCLC)单发极小脑转移瘤(BM;总肿瘤体积[GTV]≤1 cm3)分段低分割立体定向放疗(3F-HSRT)中的临床效果,并与单弧共面体积调节电弧治疗(C-VMAT)的治疗方案进行比较。2019年12月至2023年5月,本研究纳入了20例使用C-DCA进行3f - hsrt (24-39 Gy/3f)治疗的单BM NSCLC患者。采用C-VMAT对各方案进行重新规划,并对相关规划指标进行比较。评估C-DCA治疗后的临床结果。C-VMAT具有较高的均匀性指数(1.41 vs. 1.16, p = 98%) (38.10 Gy vs. 32.72 Gy, p = 0.008),正常脑组织(NBT)的V23Gy和V21Gy略小。然而,C-DCA提供了31.37%的低监测单元(p = 0.008)和36.55%的短束时间(p = 0.007),同时实现了显著更高的2%/1 mm标准的伽马通良率(p = 0.001)。截至2023年10月,中位随访时间为9.2个月。颅内疾病控制率为70%,中位颅内无进展生存期为11.4个月(95% CI 4.5-18.3), 1年颅内控制率为45.4%。颅内局部疾病控制率为95%。在随访结束时,只有两个放射病灶进展。所有患者的脑放射性坏死率均为5%。对于小型BM, C-DCA在保持更高的投送效率和精度的同时,提供了几乎等同于C-VMAT的目标覆盖和NBT节约。C-DCA HSRT也具有良好的局部控制和有限的毒性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coplanar DCA-based hypofractionated stereotactic radiotherapy for very small brain metastasis from non-small cell lung cancer: treatment planning comparison with coplanar VMAT and preliminary clinical outcome.

To assess the clinical outcome of single-arc coplanar dynamic conformal arc (C-DCA) in three-fraction hypofractionated stereotactic radiotherapy (3F-HSRT) for single very small brain metastasis (BM; gross tumor volume [GTV] ≤ 1 cm3) from non-small cell lung cancer (NSCLC) and to compare treatment planning with single-arc coplanar volumetric modulated arc therapy (C-VMAT). From December 2019 to May 2023, twenty NSCLC patients with single BM treated with 3F-HSRT (24-39 Gy/3f) using C-DCA were enrolled in this study. Each plan was replanned using C-VMAT, and relevant planning indices were compared. Clinical outcome was evaluated following C-DCA treatment. C-VMAT yielded a higher homogeneity index (1.41 vs. 1.16, p < 0.001) and GTV D98% (38.10 Gy vs. 32.72 Gy, p = 0.008), with slightly smaller normal brain tissue (NBT) V23Gy, and V21Gy. However, C-DCA offered 31.37% lower monitor units (p = 0.008) and 36.55% shorter beam on time (p = 0.007) while achieving a significantly higher gamma passing rate for the 2%/1 mm criterion (p = 0.001). As of October 2023, the median follow-up time was 9.2 months. The intracranial disease control rate was 70%, with a median intracranial progression-free survival of 11.4 (95% CI 4.5-18.3) months and a 1-year intracranial control rate of 45.4%. The intracranial local disease control rate was 95%. Only two irradiated lesions progressed at the end of follow-up. The cerebral radiation necrosis rate of all patients was 5%. For small BM, C-DCA provided nearly equivalent target coverage and NBT sparing to the C-VMAT while maintaining higher delivery efficiency and accuracy. C-DCA HSRT also provided good local control and limited toxicity.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
8.40
自引率
4.50%
发文量
110
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信