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本文引用的文献

1
A study on conventional IMRT and RapidArc treatment planning techniques for head and neck cancers.一项关于头颈癌的传统调强放射治疗（IMRT）和容积旋转调强放疗（RapidArc）治疗计划技术的研究。
Rep Pract Oncol Radiother. 2012 Mar 3;17(3):168-75. doi: 10.1016/j.rpor.2012.01.009. eCollection 2012.
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Reirradiation of relapsed brain tumors in children.儿童复发性脑肿瘤的再照射
Rep Pract Oncol Radiother. 2011 Nov 13;17(1):32-7. doi: 10.1016/j.rpor.2011.10.004. eCollection 2011.
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Squamous cell carcinoma of the head and neck-The role of diffusion and perfusion imaging in tumor recurrence and follow-up.头颈部鳞状细胞癌——扩散与灌注成像在肿瘤复发及随访中的作用
Rep Pract Oncol Radiother. 2011 Jul 19;16(6):207-12. doi: 10.1016/j.rpor.2011.06.006.
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Volumetric modulation arc radiotherapy with flattening filter-free beams compared with static gantry IMRT and 3D conformal radiotherapy for advanced esophageal cancer: a feasibility study.容积调强弧形放疗联合非调强适形放疗与静态旋转调强放疗治疗局部晚期食管癌的可行性研究。
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):553-60. doi: 10.1016/j.ijrobp.2011.12.041. Epub 2012 Mar 2.
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In regard to "ACR appropriateness criteria of recurrent head-and-neck cancer after prior definitive radiation." (Int J Radiat Oncol Biol Phys 2011;80:1292-1298).关于“先前根治性放疗后复发性头颈癌的美国放射学会适宜性标准”（《国际放射肿瘤学、生物学、物理学杂志》2011年；80卷：1292 - 1298页）。
Int J Radiat Oncol Biol Phys. 2012 Mar 15;82(4):1322-3; author reply 1315-6. doi: 10.1016/j.ijrobp.2011.11.049.
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Pretreatment quality assurance of flattening filter free beams on 224 patients for intensity modulated plans: a multicentric study.224 例调强计划中使用无均整过滤器射束的预处理质量保证：一项多中心研究。
Med Phys. 2012 Mar;39(3):1351-6. doi: 10.1118/1.3685461.
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Can volumetric modulated arc therapy with flattening filter free beams play a role in stereotactic body radiotherapy for liver lesions? A volume-based analysis.容积调强弧形治疗技术（FFF 模式）在立体定向体部放疗治疗肝脏病变中是否有作用？一项基于体积的分析。
Med Phys. 2012 Feb;39(2):1112-8. doi: 10.1118/1.3679858.
8
Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations.立体定向体部放射治疗肝脏肿瘤使用非均整滤过射束：剂量学和技术考虑。
Radiat Oncol. 2012 Feb 1;7:16. doi: 10.1186/1748-717X-7-16.
9
Feasibility and early clinical assessment of flattening filter free (FFF) based stereotactic body radiotherapy (SBRT) treatments.基于调强适形放疗（FFF）的立体定向体部放疗（SBRT）治疗的可行性和早期临床评估。
Radiat Oncol. 2011 Sep 12;6:113. doi: 10.1186/1748-717X-6-113.
10
Current status and future perspective of flattening filter free photon beams.调强适形放射治疗中使用非均整滤过光子射束的现状和未来展望。
Med Phys. 2011 Mar;38(3):1280-93. doi: 10.1118/1.3554643.

在复发性鼻咽癌的选定病例报告中，使用真光束和无均整器光束进行大分割放射再治疗的初步经验。

Initial experience of hypofractionated radiation retreatment with true beam and flattening filter free beam in selected case reports of recurrent nasopharyngeal carcinoma.

作者信息

Alongi Filippo, Clerici Elena, Pentimalli Sara, Mancosu Pietro, Scorsetti Marta

机构信息

Radiotherapy and Radiosurgery Department, Humanitas Cancer Center, Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Milan, Italy.

出版信息

Rep Pract Oncol Radiother. 2012 Aug 10;17(5):262-8. doi: 10.1016/j.rpor.2012.07.012. eCollection 2012 Sep.

DOI:10.1016/j.rpor.2012.07.012
PMID:24669306
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3885887/
Abstract

AIM

To show our preliminary experience in using TrueBeam with RapidArc technology and FFF beam for stereotactic re-irradiation of nasopharyngeal carcinoma.

BACKGROUND

Thanks to new advanced techniques, as well as intensity modulated radiation therapy, it is possible to approach head and neck recurrences in selected patients. Volumetric Modulated Arc Therapy (VMAT) in its RapidArc(®) format, permits to reduce significantly the time to deliver complex intensity modulated plans, allowing to treat hypofractionated regimes within a few minutes. With TrueBeam it is possible to perform photon beams without usage of the flattening filter. It seems possible to expect a reduction of out-of-field dose when flattening filter free (FFF) beams are used. While research into the physics domain for FFF beams is increasing, there are very few clinical data where FFF beams are applied in clinical practice.

MATERIALS AND METHODS

We present here the cases of 4 patients with local or regional recurrence of nasopharyngeal carcinoma. All patients were treated using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation.

RESULTS

All patients concluded SBRT and showed good tolerability. During follow-up, complete response at imaging evaluation (PET and/or MRI) for all treated patients was documented.

CONCLUSIONS

Our preliminary experience using TrueBeam with RapidArc technology and FFF beam for stereotactic hypofractionated re-irradiation of nasopharyngeal carcinoma was safe and effective in all 4 treated patients. Longer follow-up and a larger population of study is needed to confirm these promising results.

摘要

目的

展示我们使用TrueBeam直线加速器结合容积弧形调强放疗（RapidArc）技术及FFF束流对鼻咽癌进行立体定向再程放疗的初步经验。

背景

由于新的先进技术以及调强放射治疗，对于部分特定患者的头颈部复发肿瘤有了新的治疗方法。容积弧形调强放疗（VMAT）的RapidArc（®）模式能够显著缩短复杂调强放疗计划的执行时间，从而在几分钟内完成大分割放疗方案。TrueBeam直线加速器能够产生无均整器的光子束流。使用无均整器（FFF）束流有望减少射野外剂量。虽然关于FFF束流的物理领域研究日益增多，但在临床实践中应用FFF束流的临床数据却很少。

材料与方法

我们在此展示4例鼻咽癌局部或区域复发患者的病例。所有患者均采用TrueBeam直线加速器结合RapidArc技术及FFF束流进行立体定向大分割再程放疗。

结果

所有患者均完成立体定向体部放疗（SBRT），耐受性良好。随访期间，所有接受治疗的患者经影像学评估（PET和/或MRI）均显示完全缓解。

结论

我们使用TrueBeam直线加速器结合RapidArc技术及FFF束流对鼻咽癌进行立体定向大分割再程放疗的初步经验表明，这一方法对于所有4例接受治疗的患者均安全有效。需要更长时间的随访和更大规模的研究人群来证实这些令人鼓舞的结果。