Key Laboratory of Translational Radiation Oncology, Department of Radiation Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Hunan Province, China.
Department of Radiotherapy Technology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, China.
Biomed Res Int. 2017;2017:9736362. doi: 10.1155/2017/9736362. Epub 2017 May 28.
Many studies have demonstrated that a higher radiotherapy dose is associated with improved outcomes in non-small-cell lung cancer (NSCLC). We performed a dosimetric planning study to assess the dosimetric feasibility of intensity-modulated radiation therapy (IMRT) with a simultaneous integrated boost (SIB) in locally advanced NSCLC.
We enrolled twenty patients. Five different dose plans were generated for each patient. All plans were prescribed a dose of 60 Gy to the planning tumor volume (PTV). In the three SIB groups, the prescribed dose was 69 Gy, 75 Gy, and 81 Gy in 30 fractions to the internal gross tumor volume (iGTV).
The SIB-IMRT plans were associated with a significant increase in the iGTV dose ( < 0.05), without increased normal tissue exposure or prolonged overall treatment time. Significant differences were not observed in the dose to the normal lung in terms of the V5 and V20 among the four IMRT plans. The maximum dose (Dmax) in the esophagus moderately increased along with the prescribed dose ( < 0.05).
Our results indicated that escalating the dose by SIB-IMRT is dosimetrically feasible; however, systematic evaluations via clinical trials are still warranted. We have designed a further clinical study (which is registered with ClinicalTrials.gov, number NCT02841228).
许多研究表明，非小细胞肺癌（NSCLC）的放疗剂量越高，疗效越好。我们进行了一项剂量学规划研究，以评估局部晚期 NSCLC 中调强放疗（IMRT）同步整合增量放疗（SIB）的剂量学可行性。
我们纳入了 20 例患者。为每位患者生成了 5 种不同的剂量计划。所有计划均规定 PTV 接受 60Gy 的剂量。在 3 个 SIB 组中，iGTV 接受 69Gy、75Gy 和 81Gy 的 30 次分割处方剂量。
SIB-IMRT 计划可显著增加 iGTV 剂量（<0.05），而不会增加正常组织的暴露或延长总治疗时间。4 种 IMRT 计划中，正常肺的 V5 和 V20 剂量无显著差异。随着处方剂量的增加（<0.05），食管的最大剂量（Dmax）也适度增加。
我们的结果表明，SIB-IMRT 递增剂量在剂量学上是可行的；然而，仍需要通过临床试验进行系统评估。我们已经设计了进一步的临床研究（在 ClinicalTrials.gov 注册，编号为 NCT02841228）。
