伽玛刀放射外科中肿瘤细胞浸润对治疗结果的影响：一项建模研究
Impact of Tumour Cell Infiltration on Treatment Outcome in Gamma Knife Radiosurgery: A Modelling Study.
作者信息
Lazzeroni Marta, Manesh Zohreh Khazraei, Sandström Helena, Barsoum Pierre, Toma-Dasu Iuliana
机构信息
Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, Sweden
School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden.
出版信息
Anticancer Res. 2019 Apr;39(4):1675-1687. doi: 10.21873/anticanres.13273.
BACKGROUND
High-grade gliomas with a widespread infiltration beyond the lesion detectable on diagnostic images are increasingly treated with Gamma Knife™ Radiosurgery (GKRS). The aim of this study was to assess the cell infiltration impact on the GKRS outcome for invasive gliomas.
MATERIALS AND METHODS
Tumor cell distribution was predicted using a novel algorithm whose computations are iterated until they reach an agreement with histopathology results. Treatment plans with different combinations of dose prescription (20 Gy at 50%-20% isodose) and targets [Gross Tumour Volume (GTV), zone 1 with 100%-60% of the GTV cell density and zone 2 with 60%-0% of the GTV cell density] were evaluated using standard conformity indexes (CI) and radiobiological parameters.
RESULTS
Considerable differences in terms of tumor control probability were found between plans having similar CI but different targets.
CONCLUSION
To account for tumor cell infiltration outside the target is of key importance in GKRS and a radiobiological evaluation should accompany well-established CI.
背景
对于在诊断影像上可检测到的病变范围之外存在广泛浸润的高级别胶质瘤，越来越多地采用伽玛刀放射外科治疗（GKRS）。本研究的目的是评估细胞浸润对侵袭性胶质瘤GKRS治疗结果的影响。
材料与方法
使用一种新算法预测肿瘤细胞分布，其计算过程反复进行，直至与组织病理学结果达成一致。使用标准适形指数（CI）和放射生物学参数评估不同剂量处方（50%-20%等剂量线处20 Gy）和靶区[大体肿瘤体积（GTV）、GTV细胞密度100%-60%的1区和GTV细胞密度60%-0%的2区]组合的治疗计划。
结果
在具有相似CI但靶区不同的计划之间，发现肿瘤控制概率存在显著差异。
结论
在GKRS中考虑靶区外的肿瘤细胞浸润至关重要，并且应在成熟的CI基础上进行放射生物学评估。
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