Departement of Radiation Oncology, Ospedale "Mons. A. R. Dimiccoli", Viale Ippocrate 15, 70051 Barletta, Italy.
Laboratoire de physique corpusculaire IN2P3/ENSICAEN-UMR6534, boulevard du Marechal-Juin, 14050 Caen, France.
Cancer Radiother. 2021 Feb;25(1):92-102. doi: 10.1016/j.canrad.2020.06.031. Epub 2020 Dec 31.
In literature, there are no guidelines on how to prescribe dose in the case of radiosurgery (SRS) or stereotactic irradiation of multiple and adjacent BM. Aim of this work is to furnish practical proposals of dosimetric methods for multiple neighboring BM, and to make a literature review about the SRS treatment of multiple BM, comparing radiotherapy techniques on the basis of different dosimetric parameters.
A theoretical proposal of dosimetric approaches to prescribe dose in case of multiple contiguous BM is done. A literature review between 2010 and 2020 was performed on MEDLINE and Cochrane databases according to the PRISMA methodology, with the following keywords dose prescription, radiosurgery, multiple BM. Papers not reporting dosimetric solutions to irradiate multiple BM were excluded.
Only one article in the literature reports a practical modality of dose prescription for multiple adjacent BM. Thus, we proposed other five practical solutions to prescribe radiation dose in case of two or more neighboring BM, describing advantages and drawbacks of each method in terms of different dosimetric parameters. The literature review about dosimetric solutions to irradiate multiple BM led to 56 titles; 14 articles met the chosen criteria and we reported their results in terms of dosimetric indexes and low doses to the normal brain tissue.
The six dosimetric approaches here described can be used by physicians for multiple contiguous BM, depending on the clinical situation. These methods may be applied in clinical studies to better evaluate their usefulness in practice.
在文献中，对于立体定向放射外科（SRS）或多个相邻 BM 的立体定向照射，没有关于如何规定剂量的指南。本研究旨在提供多个相邻 BM 的剂量学方法的实用建议，并对 SRS 治疗多个 BM 的文献进行综述，根据不同的剂量学参数比较放射治疗技术。
对多个连续 BM 的剂量规定方法进行了理论建议。根据 PRISMA 方法，在 MEDLINE 和 Cochrane 数据库中对 2010 年至 2020 年的文献进行了回顾，使用的关键词为剂量规定、放射外科、多个 BM。排除未报告多个 BM 照射剂量学解决方案的论文。
文献中只有一篇文章报告了多个相邻 BM 的剂量规定的实际方法。因此，我们提出了另外五种在两个或多个相邻 BM 情况下规定放射剂量的实用方法，根据不同的剂量学参数描述每种方法的优缺点。关于照射多个 BM 的剂量学解决方案的文献综述导致了 56 个标题；14 篇文章符合所选标准，我们报告了他们在剂量学指标和正常脑组织低剂量方面的结果。
医生可以根据临床情况，针对多个相邻 BM 使用这里描述的六种剂量学方法。这些方法可以应用于临床研究，以更好地评估它们在实践中的有用性。
