伽玛刀Icon与基于直线加速器的分次立体定向放射治疗（FSRT）计划对大型（>14厘米）复发性胶质母细胞瘤再照射的剂量学比较。
Dosimetric comparison of Gamma Knife® Icon and linear accelerator-based fractionated stereotactic radiotherapy (FSRT) plans for the re-irradiation of large (>14 cm) recurrent glioblastomas.
作者信息
Schelin Matthew E, Liu Haisong, Ali Ayesha, Shi Wenyin, Yu Yan, Mooney Karen E
机构信息
Department of Radiation Oncology, Thomas Jefferson University, Bodine Center for Radiation Therapy, 111 S. 11th Street, Philadelphia, PA 19107, USA.
出版信息
J Radiosurg SBRT. 2021;7(3):233-243.
Our objective is to investigate dosimetric differences between clinically deliverable Gamma Knife (GK) Icon™ and linac-based FSRT plans on the basis of normal brain dose sparing for large (>14 cm) recurrent glioblastomas (GBM). Sixteen patients with large, recurrent GBM were treated using re-irradiation via linac-based FSRT, 35 Gy in 10 fractions. For each patient, a new GK FSRT plan was created in Leksell GammaPlan V11 (LGP). To maintain clinical deliverability, the LGP optimization included a planning goal of treatment time <20 minutes per fraction. Dosimetric comparison of coverage and normal brain dose between the linac and GK treatment plans was performed in MIM. The GK FSRT plans had significantly (p < 0.05) lower mean normal brain dose values (-8.85%), mean values of normal brain V20 (-32.4%) and V12 (-25.9%), and a lower mean V4 (-10.0%). GK FSRT plans have the potential to reduce the risk of radiation-related toxicities.
我们的目标是，基于对大型（>14 cm）复发性胶质母细胞瘤（GBM）的正常脑区剂量保护，研究临床可用的伽玛刀（GK）Icon™与基于直线加速器的FSRT计划之间的剂量差异。16例大型复发性GBM患者通过基于直线加速器的FSRT进行再照射治疗，分10次给予35 Gy。对于每位患者，在Leksell GammaPlan V11（LGP）中创建了一个新的GK FSRT计划。为了保持临床可实施性，LGP优化包括每个分次治疗时间<20分钟的计划目标。在MIM中对直线加速器和GK治疗计划之间的靶区覆盖和正常脑区剂量进行了剂量学比较。GK FSRT计划的平均正常脑区剂量值显著降低（p < 0.05）（-8.85%），正常脑区V20（-32.4%）和V12（-25.9%）的平均值以及平均V4（-10.0%）均较低。GK FSRT计划有可能降低放射性毒性风险。
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