Department of Radiation Oncology, St Luke's International Hospital, 9-1, Akashicho, Chuouku, Tokyo, 104-8560, Japan.
J Radiat Res. 2013 Nov 1;54(6):1065-8. doi: 10.1093/jrr/rrt044. Epub 2013 May 3.
Direct single fields are commonly used in radiotherapy for spinal bone metastases, and it is crucial to define the point for which the dose is prescribed. According to the guidelines from the International Bone Metastases Consensus Working Party (IBMCWP) updated in 2010, different opinions exist on whether this therapy should be prescribed to the mid-vertebral or anterior vertebral body. To our knowledge, no previous studies have surveyed practice patterns regarding this discrepancy. Therefore, we performed an Internet-based survey of members of the Japanese Radiation Oncology Study Group (JROSG) to investigate the current practice patterns in Japan. The respondents mentioned the point to which they prescribed radiotherapy for a single direct field. A total of 52 radiation oncologists from 50 institutions (36% of JROSG institutions) responded. Respondent prescription for radiotherapy varied widely. Only 21% and 6% of respondents prescribed irradiation to the mid-vertebral body and anterior vertebral body, respectively. A larger proportion of respondents (27%) prescribed irradiation to the spinal cord (center of the spinal canal). Still another group of respondents (27%) stated that they never use a single direct field. In conclusion, the point to which irradiation dosages are prescribed varies widely for a single direct field in cases of spinal bone metastases. This variation may lead some radiation oncologists to misunderstand the tolerance dosage of the spinal cord, especially in cases of re-irradiation. Thus, careful consideration is required before any prescriptions are made.
直接单野照射常用于脊柱骨转移的放射治疗，为规定剂量，准确界定照射点至关重要。根据国际骨骼转移共识工作组（IBMCWP）2010 年更新的指南，对于该疗法是应规定于椎体中部还是前椎体，存在不同意见。据我们所知，既往研究并未调查过这种差异的实践模式。因此，我们对日本放射肿瘤学研究组（JROSG）的成员进行了一项基于互联网的调查，以调查日本目前的实践模式。受访者提到了他们为单个直接野规定放射治疗的点。共有来自 50 个机构的 52 名放射肿瘤学家（JROSG 机构的 36%）做出了回应。受访者对放射治疗的处方差异很大。只有 21%和 6%的受访者分别规定照射到椎体中部和前椎体。更大比例的受访者（27%）规定照射到脊髓（椎管中心）。还有一组受访者（27%）表示他们从不使用单个直接野。总之，在脊柱骨转移的情况下，对于单个直接野，规定照射剂量的点差异很大。这种差异可能导致一些放射肿瘤学家误解脊髓的耐受剂量，尤其是在再照射的情况下。因此，在做出任何规定之前，需要仔细考虑。
