考虑立体定向放射外科治疗时间的脑转移瘤放射生物学评价

BJR open Pub Date : 2022-11-24 eCollection Date: 2022-01-01 DOI:10.1259/bjro.20220013
Hisashi Nakano, Takeshi Takizawa, Daisuke Kawahara, Satoshi Tanabe, Satoru Utsunomiya, Motoki Kaidu, Katsuya Maruyama, Shigekazu Takeuchi, Kiyoshi Onda, Masahiko Koizumi, Teiji Nishio, Hiroyuki Ishikawa
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引用次数: 0

摘要

我们使用CyberKnife®(CK)系统对脑转移瘤进行了立体定向放射外科(SRS)中断时间与照射时间的放射生物学效应评估。我们使用了10例接受脑SRS的非小细胞肺癌脑转移患者的DICOM数据和辐射日志文件。我们将治疗时间定义为照射过程中剂量-递送时间和中断时间的总和,并使用微剂量动力学模型(MKM)来评估治疗时间的放射生物学效应。从NCI-H460细胞中获得MKM的生物学参数,即α0、β0和DNA修复恒定速率(a+c)。我们计算了肿瘤总体积的放射生物学剂量(GTVbio),以评估治疗时间与无治疗时间相比的效果,作为参考。D95(%)和放射治疗肿瘤组一致性指数(RCI)和帕迪克一致性指数为剂量测定指数。我们使用了几种DNA修复常数率(a+c)(0.46、1.0和2.0),通过改变DNA修复日期(a+c)值来评估放射生物学效应。GTVbio的D95(%)、RCI和PCI的平均值分别为98.8%、0.90和0.80,并且随着治疗时间的增加而降低。GTVbio在2.0(a+c)值时的D95(%)、RCI和PCI的平均值分别为94.9%、0.71和0.49。使用CK的脑SRS准确评估了治疗时间对肿瘤的放射生物学影响。与使用直线加速器相比,使用CK的SRS多次中断的较长治疗时间对靶剂量分布的放射生物学效应尚未发表研究。在本研究中,考虑物理剂量中的治疗时间的放射生物学剂量评估可能允许使用CK在SRS中对转移性脑肿瘤进行更准确的剂量评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiobiological evaluation considering the treatment time with stereotactic radiosurgery for brain metastases.

Objective: We evaluated the radiobiological effect of the irradiation time with the interruption time of stereotactic radiosurgery (SRS) using CyberKnife® (CK) systemfor brain metastases.

Methods: We used the DICOM data and irradiation log file of the 10 patients with brain metastases from non-small-cell lung cancer (NSCLC) who underwent brain SRS. We defined the treatment time as the sum of the dose-delivery time and the interruption time during irradiations, and we used a microdosimetric kinetic model (MKM) to evaluate the radiobiological effects of the treatment time. The biological parameters, i.e. α0, β0, and the DNA repair constant rate (a + c), were acquired from NCI-H460 cell for the MKM. We calculated the radiobiological dose for the gross tumor volume (GTVbio) to evaluate the treatment time's effect compared with no treatment time as a reference. The D95 (%) and the Radiation Therapy Oncology Group conformity index (RCI) and Paddick conformity index (PCI) were calculated as dosimetric indices. We used several DNA repair constant rates (a + c) (0.46, 1.0, and 2.0) to assess the radiobiological effect by varying the DNA repair date (a + c) values.

Results: The mean values of D95 (%), RCI, and PCI for GTVbio were 98.8%, 0.90, and 0.80, respectively, and decreased with increasing treatment time. The mean values of D95 (%), RCI, and PCI of GTVbio at 2.0 (a+c) value were 94.9%, 0.71, and 0.49, respectively.

Conclusion: The radiobiological effect of the treatment time on tumors was accurately evaluated with brain SRS using CK.

Advances in knowledge: There has been no published investigation of the radiobiological impact of the longer treatment time with multiple interruptions of SRS using a CK on the target dose distribution in a comparison with the use of a linac. Radiobiological dose assessment that takes into account treatment time in the physical dose in this study may allow more accurate dose assessment in SRS for metastatic brain tumors using CK.

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