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使用射波刀对局部晚期不可切除胰腺癌患者进行立体定向体部放疗(SBRT)的剂量递增:一项I期研究方案

Dose escalation of Stereotactic Body Radiotherapy (SBRT) for locally advanced unresectable pancreatic cancer patients with CyberKnife: protocol of a phase I study.

作者信息

Qing Shui-Wang, Ju Xiao-Ping, Cao Yang-Sen, Zhang Huo-Jun

机构信息

Department of Radiation Oncology, Changhai Hospital, No.168 Changhai road, Shanghai, China.

出版信息

Radiat Oncol. 2017 Jan 9;12(1):6. doi: 10.1186/s13014-016-0760-1.

DOI:10.1186/s13014-016-0760-1
PMID:28069017
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5223403/
Abstract

BACKGROUND

Dose escalation of SBRT for locally advanced pancreatic cancer patients had been reported in several studies in one or three fractions, and phase I protocol was developed to investigate the maximum tolerated dose with CyberKnife for locally advanced unresectable pancreatic cancer patients in five fractions.

METHODS

The study is designed as a mono-center phase I study. The primary endpoint is to determine the maximum tolerated dose by frequency of III/IV GI (gastrointestinal) toxicity. Adverse events (AE) according to Common Toxicity Criteria (CTC) version 4. Doses of 7 Gy, 7.5 Gy, 8 Gy, 8.5 Gy, 9 Gy, 9.5Gy x 5 respectively would be delivered while meeting with normal tissue constraints. A minimum of three patients will be included for each dosage level. And an interval is 4 weeks from the first patient treatment to the next patient treatment at each dose level. The maximal tolerated dose will be defined as the dose for which at least two patients in three, or at least three patients in nine, will present with a limiting toxicity.

DISCUSSION

Since the dose and fractions of SBRT treatment for locally advanced pancreatic cancer patients are still unknown, we propose to conduct a Phase I study determining the maximum tolerated dose of CyberKnife SBRT for the treatment of locally advanced pancreatic tumor based on a 5 fractions treatment regimen. This trial protocol has been approved by the Ethics committee of Changhai hospital. The ethics number is 2016-030-01.

TRIAL REGISTRATION

Clinical trials number: NCT02716207 . Date of registration: 20 March 2016.

摘要

背景

在多项针对局部晚期胰腺癌患者的研究中,已报道了立体定向体部放疗(SBRT)在单次或三次分割照射时的剂量递增情况,并且已制定了I期方案,以研究在五分割照射时使用射波刀对局部晚期不可切除胰腺癌患者的最大耐受剂量。

方法

本研究设计为单中心I期研究。主要终点是通过III/IV级胃肠道(GI)毒性的发生率来确定最大耐受剂量。根据通用毒性标准(CTC)第4版记录不良事件(AE)。在满足正常组织限制条件的情况下,将分别给予7Gy、7.5Gy、8Gy、8.5Gy、9Gy、9.5Gy×5的剂量。每个剂量水平至少纳入三名患者。在每个剂量水平,从第一名患者治疗到下一名患者治疗的间隔为4周。最大耐受剂量将定义为在三名患者中至少有两名,或在九名患者中至少有三名出现剂量限制性毒性的剂量。

讨论

由于局部晚期胰腺癌患者的SBRT治疗剂量和分割次数仍不清楚,我们建议进行一项I期研究,以确定基于五分割治疗方案的射波刀SBRT治疗局部晚期胰腺肿瘤的最大耐受剂量。本试验方案已获得长海医院伦理委员会的批准。伦理编号为2016 - 030 - 01。

试验注册

临床试验编号:NCT0271620 – 7。注册日期:2016年3月20日。

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The radiobiology of hypofractionation.大分割放疗的放射生物学
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Stereotactic body radiation therapy for locally advanced and borderline resectable pancreatic cancer is effective and well tolerated.立体定向体部放疗治疗局部进展期和边界可切除胰腺癌是有效和耐受良好的。
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