Department of Radiation Oncology, Paris Descartes University, Sorbonne Paris Cité, Hôpital Européen Georges Pompidou, Paris, France.
J Thorac Oncol. 2011 Dec;6(12):2058-68. doi: 10.1097/JTO.0b013e3182307ec2.
The primary objective of the STIC 2003 project was to compare the clinical and economic aspects of respiratory-gated conformal radiotherapy (RGRT), an innovative technique proposed to limit the impact of respiratory movements during irradiation, versus conventional conformal radiotherapy, the reference radiation therapy for lung cancer.
A comparative, nonrandomized, multicenter, and prospective cost toxicity analysis was performed in the context of this project between April 2004 and June 2008 in 20 French centers. Only the results of the clinical study are presented here, as the results of the economic assessment have been published previously.
The final results based on 401 evaluable patients confirm the feasibility and good reproducibility of the various RGRT systems. The results of this study demonstrated a marked reduction of dosimetric parameters predictive of pulmonary, cardiac and esophageal toxicity as a result of the various respiratory gating techniques. These dosimetric benefits were mainly observed with deep inspiration breath-hold (DIBH) techniques (ABC and SDX systems), which markedly increased the total lung volume compared with the inspiration-synchronized system based on tidal volume (Real-time Position Management). These theoretical dosimetric benefits were correlated clinically with a significant reduction of pulmonary acute toxicity, and the pulmonary, cardiac, and esophageal late toxicities, especially with DIBH techniques. Pulmonary function parameters, although more heterogeneous, especially DLCO, showed a tendency to reduction of pulmonary toxicity in the RGRT group.
RGRT seems to be essential to reduce toxicities, especially the pulmonary, cardiac, and esophageal late toxicities with the DIBH methods.
STIC 2003 项目的主要目的是比较呼吸门控适形放疗（RGRT）与常规适形放疗的临床和经济方面，前者是一种创新性技术，旨在限制放疗过程中呼吸运动的影响，后者是肺癌的标准放疗。
在 2004 年 4 月至 2008 年 6 月期间，在法国的 20 个中心，进行了一项比较、非随机、多中心、前瞻性的成本-毒性分析。这里只介绍临床研究的结果，因为经济评估的结果已经发表过了。
基于 401 例可评估患者的最终结果，证实了各种 RGRT 系统的可行性和良好的可重复性。这项研究的结果表明，各种呼吸门控技术显著降低了预测肺部、心脏和食管毒性的剂量学参数。这些剂量学的益处主要是由于深吸气屏气（DIBH）技术（ABC 和 SDX 系统）实现的，与基于潮气量的吸气同步系统（实时位置管理）相比，DIBH 技术显著增加了全肺体积。这些理论上的剂量学益处与肺部急性毒性、肺部、心脏和食管迟发性毒性的显著降低相关，尤其是 DIBH 技术。肺功能参数虽然更具异质性，尤其是 DLCO，但在 RGRT 组中也显示出降低肺部毒性的趋势。
RGRT 似乎对于降低毒性，特别是 DIBH 方法的肺部、心脏和食管迟发性毒性是必要的。
