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Planning issues on linac-based stereotactic radiotherapy

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World Journal of Clinical Cases 2022年第35期10卷 12822-12836页

作者： Yang-Yang Huang Jun Yang Yi-Bao Liu School of Nuclear Science and Engineering East China University of TechnologyNanchang 330013Jiangxi ProvinceChina Department of radiotherapy The Second Affiliated Hospital of Zhengzhou UniversityZhengzhou 450014Henan ProvinceChina Department of radiotherapy The Third Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina

This work aims to summarize and evaluate the current planning progress based on the linear accelerator in stereotactic radiotherapy(SRT).The specific techniques include 3-dimensional conformal radiotherapy,dynamic conformal arc therapy,intensity-modulated radiotherapy,and volumetric-modulated arc therapy(VMAT).They are all designed to deliver higher doses to the target volume while reducing damage to normal tissues;among them,VMAT shows better prospects for *** paper reviews and summarizes several issues on the planning of SRT to provide a reference for clinical application.

关键词： stereotactic radiotherapy Treatment technology Energy Isocenters Coplanar/noncoplanar fields Calculation algorithm Multileaf collimator leaf width Flattening filter free mode Small field dosimetry Grid size

stereotactic radiotherapy for the treatment of nasopharyngeal carcinoma: a Meta-analysis of 1371 cases in China

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Oncology and Translational Medicine 2019年第6期5卷 293-300页

作者： Hanyou Xu Department of High Dependency Unit Tongxiong Oriental Hospital

Objective The aim of this study was to clarify the outcomes of stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma and to promote scientific clinical treatment and research on it in China and other countries by creating a large data *** This Meta-analysis conducted a literature search using the China National Knowledge Infrastructure database for all clinical research articles on stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal carcinoma in *** on patient cohort numbers and other research factors were recorded for every relevant clinical research *** and analyzed these fact sheets to pave the way for the objective of this *** A total of 40 clinical research articles including 1,371 patients in China from 1998 to 2012 were *** average cohort size was 34 patients(range 9-98 patients).The average total radiation dose range was 16-33.6 *** average study or treatment duration was 3.51 *** calculated average follow-up time was 31.59 *** The study provided the largest resource for further research and Meta-analyses to determine the clinical pathway of stereotactic radiotherapy for the treatment of local residual and(or) local recurrent nasopharyngeal *** results indicated that variability in the total radiation dose,treatment or research time,and follow-up duration may have contributed to the complications and side effects of stereotactic radiotherapy for local residual and(or) local recurrent nasopharyngeal carcinoma in *** calculated average total radiation dose,follow-up time,and treatment and research durations may be referenced for future treatment and *** study also proposed worldwide cooperation for the metaanalysis of research articles on stereotactic radiotherapy for treating local residual and(or) local recurrent nasopharyngeal carcinoma.

关键词： stereotactic radiotherapy residual nasopharyngeal carcinoma recurrent nasopharyngeal carcinoma Meta-analysis total radiation dose radiotherapy

Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: A case report

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World Journal of Gastroenterology 2005年第31期11卷 4923-4926页

作者： Gerhild Becker Felix Momm Henning Schwacha Norbert Hodapp Henning Usadel Michael GeiBler Annette Barke Annette Schmitt-Gr(a|¨)ff Karl Henne Hubert E. Blum Department of Medicine Ⅱ Department of radiotherapy Institute of Pathology

In view of the poor prognosis of patients with cholangiocarcinoma （CCC）, there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. radiotherapy is an effective alternative to surgery for hilar CCC （Klatskin tumors） if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disdplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy （3×4 Gy/wk） was administered. Therapy was well tolerated. After 32 too, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.

关键词： Klatskin tumor stereotactic radiotherapy Inter-disciplinary treatment

Fractionated stereotactic radiotherapy with vagina carotica protection technique for local residual nasopharyngeal carcinoma after primary radiotherapy

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Chinese Medical Journal 2012年第14期125卷 2525-2529页

作者： LIU Feng XIAO Jian-ping XU Ying-jie ZHANG Ye XU Guo-zhen GAO Li YI Jun-lin LUO Jing-wei HUANG Xiao-dong HUAN Fu-kui FANG Hao WAN Bao LI Ye-xiong Department of Radiation Oncology Cancer Hospital ChineseAcademy of Medical Sciences and Peking Union Medical CollegeBeijing 100021 China

Background Local failure of nasopharyngeal carcinoma （NPC） after radiotherapy （RT） remains one of the major treatment failures. This study aimed to evaluate the clinical efficacy and complications of fractionated stereotactic radiotherapy （FSRT） with vagina carotica protection technique for local residual of NPC patients after the primary RT. Methods From August 2006 to August 2010, FSRT with vagina carotica protection technique was applied to 36 patients in our department, the patients aged between 13 and 76 years with a median of 41.3 years, 25 of them were male and 11 were female. According to 2002 Union for International Cancer Control （UICC） Staging System, the stages before primary radiotherapy were： Ila 2, lib 5, III 18, IVa 7, IVb 4. In the first course of radiotherapy, 9 patients received conventional RT, 27 patients received intensity modulated radiotherapy （IMRT） and 20 out of the 36 patients received concurrent chemoradiotherapy. The total dose in the first course of RT was 69.96-76.90 Gy （median, 72.58 Gy）. The intervals between the primary RT and FSRT ranged from 12 to 147 days （median, 39.8 days）. Target volumes ranged from 1.46 to 32.98 cm3 （median, 14.94 cm3）. The total FSRT doses were 10.0-24.0 Gy （median, 16.5 Gy） with 2.0-5.0 Gy per fraction. The most common regimen was 15 Gy in 5 fractions of 3 Gy, the irradiation dose to vagina carotica was less than 2 Gy per fraction. Results The median follow-up time was 34 months （range, 12-59 months）. The 3-year local control rate was 100%; the 3-year overall survival rate was 94.4%; the 3-year disease-free survival rate was 77.8%. In this study, we had one case of cranial nerve injury, two cases of temporal lobe necrosis, and no nasopharyngeal massive hemorrhage was observed. Conclusion FSRT with vagina carotica protection technique is an effective and safe RT regimen for local residual of NPC with reduction of radiation-related neurovascular lesions.

关键词： nasophaJTngeal carcinoma residual lesions stereotactic radiotherapy boost irradiation

Effects of Different Doses of stereotactic radiotherapy on Recurrence,Metastasis and Survival of Patients with Lung Cancer

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Proceedings of Anticancer Research 2021年第2期5卷 1-4页

作者： Liwei Zhang Hefei Cancer Hospital Chinese Academy of SciencesHefei 230031Anhui ProvinceChina

Objective:To investigate the effect of different doses of stereotactic radiotherapy(SBRT)on the recurrence,metastasis and survival of lung cancer ***:The clinical data of 13 patients with lung cancer who were treated in our hospital from May 2016 to June 2020 and were followed up for one year were retrospectively *** patients treated with low-dose SBRT were divided into the observation group(7 cases)and the patients treated with high-dose SBRT were divided into the control group(6 cases).The clinical efficacy,recurrence,metastasis,survival status and incidence of adverse reactions were compared between the two ***:There were no significant differences in the clinical total effective rate,1-year recurrence rate,metastasis rate and survival rate between the two groups(P>0.05);The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:High dose or low dose SBRT can achieve good curative effect and prognosis in patients with lung cancer,but low dose SBRT has less adverse reactions and higher safety.

关键词： Lung cancer stereotactic radiotherapy Recurrence Transfer Living conditions

Observation of the therapeutic efficacy of stereotactic radiotherapy in 44 cases of retroperitoneal metastatic tumor

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The Chinese-German Journal of Clinical Oncology 2006年第5期5卷 347-349页

作者： Qingsong Xi Shiying Yu Guangyuan Hu Cancer Center of Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

Objective: To investigate the therapeutic effects of stereotactic radiotherapy for retroperitoneal metastatic tumor. Methods: From August 1997 to October 2004, 44 patients with retroperitoneal metastatic tumors were treated with stereotactic radiotherapy. The planning target volume was encompassed by 90%–95% isodose line. Fractional dose was from 6 Gy to 8 Gy, and they were treated 2–3 times per-week and 4–8 times in all. The total radiation doses of PTV were from 32 Gy to 48 Gy. Re- sults: After the radiotherapy, the pain was obviously relieved in 81.8% patients. Three months after completion of radiotherapy passed and then, abdominal CT was performed to evaluate the results. The whole effective rate was 81.8% [CR 27.7% (12/44) and PR 54.5% (24/44)], and six months after radiotherapy, CR was 27.7% (12/44) and PR was 59.1% (26/44). The middle survival time was 12 months. Conclusion: It is suggested that stereotactic radiotherapy for retroperitoneal metastatic tumor is a safe and effective method.

关键词： retroperitoneal metastatic tumor stereotactic radiotherapy fractionated stereotactic radiotherapy

stereotactic body radiotherapy for oligo-recurrence within the nodal area from colorectal cancer

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World Journal of Gastroenterology 2014年第8期20卷 2005-2013页

作者： Young Seok Seo Mi-Sook Kim Hyung-Jun Yoo Won-Il Jang Department of Radiation Oncology Korea Cancer Center HospitalKorea Institute of Radiological and Medical SciencesSeoul 139-706South Korea

Recurrence of colorectal cancer(CRC)often presents as solitary metastases,oligometastases or *** resection became the preferred treatment for patients with CRC lung and hepatic ***,surgical treatment for oligo-recurrence within nodal area is not a widely accepted treatment due to due to their relative rarity and high postoperative *** body radiotherapy(SBRT)is one of the emerging radiation treatment techniques in which a high radiation dose can be delivered to the ***-dose SBRT can ablate the tumor with an efficacy similar to that achieved with surgery,especially for small ***,there have been very few studies on SBRT for oligo-recurrence within nodal area,although several studies have evaluated the role of SBRT in the treatment of liver and lung metastases from *** article reviews the current clinical status of and treatment methods for oligo-recurrence within nodal area from CRC,with particular emphasis on SBRT.

关键词： Colorectal cancer Oligo-recurrence Oligometastases stereotactic radiotherapy Lymph node

Dosimetric consequences of tumor volume changes after kilovoltage cone-beam computed tomography for non-operative lung cancer during adaptive intensity-modulated radiotherapy or fractionated stereotactic radiotherapy

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Oncology and Translational Medicine 2015年第5期1卷 195-200页

作者： Jian Hu Ximing Xu Guangjin Yuan Wei Ge Liming Xu Aihua Zhang Junjian Deng Cancer Center Renmin Hospital of Wuhan University Department of Oncology Qianjiang Nationality Hospital

Objective The aim of this study was to investigate tumor volume changes with kilovoltage cone-beam computed tomography （kV-CBCT） and their dosimetric consequences for non-operative lung cancer during intensity-modulated radiotherapy （IMRT） or fractionated stereotactic radiotherapy. Methods Eighteen patients with non-operative lung cancer who received IMRT consisting of 1.8-2.2 Gy/fraction and five fractions per week or stereotactic radiotherapy with 5-8 Gy/fraction and three fractions a week were studied, kV-CBCT was performed once per week during IMRT and at every fraction during stereotactic radiotherapy. The gross tumor volume （GTV） was contoured on the kV-CBCT images, and adaptive treatment plans were created using merged kV-CBCT and primary planning computed tomogra- phy image sets. Tumor volume changes and dosimetric parameters, including the minimum dose to 95% （D95） or 1% （D1） of the planning target volume （PTV）, mean lung dose （MLD）, and volume of lung tissue that received more than 5 （Vs）, 10 （Vl0）, 20 （V20）, and 30 （V30） Gy were retrospectively analyzed. Results The average maximum change in GTV observed during IMRT or fractionated stereotactic radio- therapy was -25.85% （range, -13.09% --56.76%）. The D95 and Dr of PTV for the adaptive treatment plans in all patients were not significantly different from those for the initial or former adaptive treatment plans. In patients with tumor volume changes of 〉20% in the third or fourth week of treatment during IMRT, adap- tive treatment plans offered clinically meaningful decreases in MLD and V5, V10, V20, and V30; however, in patients with tumor volume changes of 〈 20% in the third or fourth week of treatment as well as in patients with stereotactic radiotherapy, there were no significant or clinically meaningful decreases in the dosimetric parameters. Conclusion Adaptive treatment planning for decreasing tumor volume during IMRT may be beneficial for patients who experience tumor volume changes of 〉20% in the

关键词： lung cancer kilovoltage cone-beam computed tomography (kV-CBCT) intensity-modulated radiotherapy (IMRT) stereotactic radiotherapy tumor changes adaptive planning

radiotherapy of brain metastases from non-small cell lung cancer

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Journal of Cancer Metastasis and Treatment 2019年第2期4卷 39-50页

作者： Esra Korkmaz KirakIi Ufuk YiImaz Department of Radiation Oncology Dr.Suat Seren Chest Disease and Surgery Training and Research Hospitalİzmir 35200Turkey Department of Pulmonology University of Health ScienceDr.Suat Seren Chest Disease and Surgery Training and Research Hospitalİzmir 35200Turkey

Brain metastases risk at the time of diagnosis or during the course of disease is high in non-small cell lung cancer (NSCLC). Even the incidence of brain metastases has increased in recent years, due to detection of smaller asymptomatic lesions with MRI screening as well as improved survival as a consequence of developments in systemic therapies. In the last decade, there have been many trials in the management of NSCLC patients with brain metastases, questioning the role of adjuvant whole brain radiotherapy (WBRT) after surgery or stereotactic radiosurgery (SRS), WBRT, compared to best supportive care in patients not amenable to surgery, aggressive local therapies in solitary brain metastases, postsurgical cavity SRS, SRS in non-oligometastatic patients, cranial radiotherapy in patients with driver mutations, thyrosine kinase inhibitors, immune check point inhibitors and the impact of therapies on neurocognitive functions and quality of life. The main objective of this review is to provide an update on current trends in radiotherapy in the management of newly diagnosed brain metastases from NSCLC.

关键词： radiotherapy whole-brain radiotherapy stereotactic radiotherapy stereotactic radiosurgery brain metastases lung cancer