Nishio Teiji, Kunieda Etsuo, Shirato Hiroki, Ishikura Satoshi, Onishi Hiroshi, Tateoka Kunihiko, Hiraoka Masahiro, Narita Yuichirou, Ikeda Masataka, Goka Tomonori
Radiation Oncology Division, National Cancer Center Hospital East, Kashiwa, Japan.
Phys Med Biol. 2006 Nov 7;51(21):5409-17. doi: 10.1088/0031-9155/51/21/002. Epub 2006 Oct 6.
A multicentre phase II trial of stereotactic body radiotherapy for T1N0M0 non-small cell lung cancer was initiated in Japan as the Japan Clinical Oncology Group trial (JCOG0403). Before starting the trial, a decision was made to evaluate the treatment machine and treatment planning in participating institutions to minimize the variations of the prescription dose between the institutions. We visited the 16 participating institutions and examined the absolute dose at the centre of a simulated spherical tumour of 3.0 cm diameter in the lung using the radiation treatment planning systems in each institution. A lung phantom for stereotactic body radiotherapy (SBRT) was developed and used for the treatment planning and film dosimetry. In the JCOG radiotherapy study group, the no model-based calculation algorithm or the model-based calculation algorithm with a dose kernel unscaled for heterogeneities were selected for use in the initial SBRT trials started in 2004, and the model-based calculation algorithm with a dose kernel scaled for heterogeneities was selected for the coming trial. The findings of this study suggest that the clinical results of lung SBRT trials should be carefully evaluated in comparison with the actual dose given to patients.
一项针对T1N0M0非小细胞肺癌的立体定向体部放疗多中心II期试验在日本启动，作为日本临床肿瘤学会试验（JCOG0403）。在试验开始前，决定对参与机构的治疗设备和治疗计划进行评估，以尽量减少各机构之间处方剂量的差异。我们走访了16个参与机构，使用各机构的放射治疗计划系统，检测了肺内一个直径3.0厘米模拟球形肿瘤中心的绝对剂量。开发了一种用于立体定向体部放疗（SBRT）的肺部体模，并将其用于治疗计划和胶片剂量测定。在JCOG放疗研究组中，2004年开始的初始SBRT试验选用了无基于模型的计算算法或未针对不均匀性进行剂量核缩放的基于模型的计算算法，而即将开展的试验则选用了针对不均匀性进行剂量核缩放的基于模型的计算算法。本研究结果表明，与给予患者的实际剂量相比，肺部SBRT试验的临床结果应得到仔细评估。
