BMC Cancer. 2013 Aug 10;13:381. doi: 10.1186/1471-2407-13-381.
The kidneys are a principal dose-limiting organ in radiotherapy for upper abdominal cancers. The current understanding of kidney radiation dose response is rudimentary. More precise dose-volume response models that allow direct correlation of delivered radiation dose with spatio-temporal changes in kidney function may improve radiotherapy treatment planning for upper-abdominal tumours.
METHODS/DESIGN: The Radiotherapy of Abdomen with Precise Renal Assessment with SPECT/CT Imaging (RAPRASI) is an observational clinical research study with participating sites at Sir Charles Gairdner Hospital (SCGH) in Perth, Australia and the Peter MacCallum Cancer Centre (PMCC) in Melbourne, Australia. Eligible patients are those with upper gastrointestinal cancer, without metastatic disease, undergoing conformal radiotherapy that will involve incidental radiation to one or both kidneys. For each patient, total kidney function is being assessed before commencement of radiotherapy treatment and then at 4, 12, 26, 52 and 78 weeks after the first radiotherapy fraction, using two procedures: a Glomerular Filtration Rate (GFR) measurement using the 51Cr-ethylenediamine tetra-acetic acid (EDTA) clearance; and a regional kidney perfusion measurement assessing renal uptake of 99mTc-dimercaptosuccinic acid (DMSA), imaged with a Single Photon Emission Computed Tomography / Computed Tomography (SPECT/CT) system. The CT component of the SPECT/CT provides the anatomical reference of the kidney's position. The data is intended to reveal changes in regional kidney function over the study period after the radiotherapy. These SPECT/CT scans, co-registered with the radiotherapy treatment plan, will provide spatial correlation between the radiation dose and regional renal function as assessed by SPECT/CT. From this correlation, renal response patterns will likely be identified with the purpose of developing a predictive model.
Australian New Zealand Clinical Trials Registry: ACTRN12609000322235.
肾脏是上腹部癌症放射治疗的主要剂量限制器官。目前对肾脏辐射剂量反应的了解还很初步。更精确的剂量-体积反应模型，可使辐射剂量与肾脏功能的时空变化直接相关，这可能会改善上腹部肿瘤的放射治疗计划。
方法/设计：腹部放射治疗中精确肾评估的 SPECT/CT 成像（RAPRASI）是一项观察性临床研究，参与地点在澳大利亚珀斯的查尔斯·盖尔德纳爵士医院（SCGH）和澳大利亚墨尔本的彼得·麦卡伦癌症中心（PMCC）。符合条件的患者是患有上胃肠道癌、无转移疾病、接受适形放射治疗的患者，放射治疗会意外照射到一个或两个肾脏。对于每位患者，在开始放射治疗前以及在第一次放射治疗后 4、12、26、52 和 78 周，使用两种程序评估总肾功能：使用 51Cr-乙二胺四乙酸（EDTA）清除率测量肾小球滤过率（GFR）；以及评估肾脏摄取 99mTc-二巯丁二酸（DMSA）的区域肾脏灌注测量，使用单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）系统进行成像。SPECT/CT 的 CT 组件提供了肾脏位置的解剖参考。该数据旨在揭示放射治疗后研究期间区域肾功能的变化。这些 SPECT/CT 扫描与放射治疗计划共同注册，将在 SPECT/CT 评估的区域肾功能与辐射剂量之间提供空间相关性。从这种相关性中，可能会确定肾脏反应模式，目的是开发预测模型。
澳大利亚和新西兰临床试验注册中心：ACTRN12609000322235。
