Adam J F, Biston M C, Rousseau J, Boudou C, Charvet A M, Balosso J, Estève F, Elleaume H
Institut National de la Santé et de la Recherche Médicale, Unite 836, Grenoble Institut des Neurosciences, Equipe 6 Rayonnement Synchrotron et recherche Médicale, ESRF Medical Beamline, BP 220, 38043 Grenoble Cedex 9, France.
Phys Med. 2008 Jun;24(2):92-7. doi: 10.1016/j.ejmp.2008.02.003. Epub 2008 Apr 14.
Synchrotron stereotactic radiotherapy (SSR) is a treatment that involves selective accumulation of high-Z elements in tumours followed by stereotactic irradiation, in CT mode, with monochromatic X-rays from a synchrotron source, tuned at an optimal energy. The irradiation geometry, characteristic X-rays, photoelectrons, and Auger electrons generated on high-Z atoms by kilovoltage X-rays produce a localized dose enhancement. Two complimentary SSR approaches have been successfully developed in the past 5 years in our team, and may be promising in high-grade glioma management: iodine-enhanced SSR, with an iodinated contrast agent; and Pt-enhanced SSR; a concomitant radio-chemotherapy treatment with locoregional injection of platinated chemotherapy drugs. The results for iodine-enhanced SSR using contrast agents are presented in this paper. IUdR-enhanced SSR was also tested in this study. Up to 15 Gy, intracarotid infusion of iodine significantly improved the rats' survival compared to irradiation alone. SSR provides the most protracted survivals of F98 glioma-bearing rats. The technique is currently transferred to clinical trials. Iodine-enhanced SSR will be implemented first, because of its simplicity; and pave the way for Pt-enhanced SSR, the most efficient technique, but still needing to be improved in terms of intrinsic toxicity.
同步加速器立体定向放射治疗(SSR)是一种治疗方法,它包括在肿瘤中选择性积累高Z元素,然后在CT模式下用来自同步加速器源的单色X射线进行立体定向照射,且X射线能量调至最佳。千伏级X射线在高Z原子上产生的照射几何形状、特征X射线、光电子和俄歇电子会产生局部剂量增强。在过去5年里,我们团队成功开发了两种互补的SSR方法,在高级别胶质瘤治疗中可能很有前景:碘增强SSR,使用碘化造影剂;以及铂增强SSR,通过局部注射铂类化疗药物进行同步放化疗。本文展示了使用造影剂的碘增强SSR的结果。本研究还测试了碘脱氧尿苷(IUdR)增强SSR。与单纯照射相比,颈动脉内注入碘高达15 Gy时显著提高了大鼠的生存率。SSR使携带F98胶质瘤的大鼠存活时间最长。该技术目前正在转入临床试验。由于碘增强SSR操作简单,将首先实施;并为铂增强SSR铺平道路,铂增强SSR是最有效的技术,但在固有毒性方面仍需改进。