Ohmatsu Kenta, Hashimoto Yaichiro, Kuribayashi Shigehiko, Toramatsu Chie, Lee Kiwoo, Kono Sawa, Kawanishi Miki, Karasawa Kumiko
Department of Radiation Oncology, Tokyo Women's Medical University, Tokyo, Japan.
Cancer Diagn Progn. 2023 Jan 3;3(1):91-95. doi: 10.21873/cdp.10184. eCollection 2023 Jan-Feb.
BACKGROUND/AIM: To identify predictors of adverse gastrointestinal (GI) events related to stereotactic body radiation therapy (SBRT) for liver tumors.
We retrospectively analyzed 56 patients who underwent SBRT for liver tumors at our institution between 2016 and 2021. The α/β ratio of the GI tract (stomach, duodenum, and large intestine) was assumed to be 3 Gy in the Linear-Quadratic model (LQ model). The dose to the GI tract, that is, the biologically effective dose 3 (BED3) was converted to a 2 Gy equivalent dose (Gy2/3=2 Gy equivalent dose, α/β=3). Using this 2 Gy equivalent dose, predictors of adverse GI events of Grade 2 or higher were investigated.
The median observation period was 10 months (0-40 months) and median age was 77 years (range=29-93 years). Forty-three of the 56 patients had hepatocellular carcinoma and the other 13 had metastatic liver tumors. Tumors were irradiated with 30-54 Gy/5-18 fractions of planning target volume D95% prescription (80% isodose). Eight of the 56 patients had Grade 2 or higher adverse GI events. By univariate analysis, GI D1cc, Dmax, V20, V25, V30, and V35 were all significant predictors of Grade 2 or higher adverse GI events. Among these, gastrointestinal V35 was the most significant predictor of Grade 2 or higher adverse GI events.
For SBRT of liver tumors, GI V35 was the best predictor of Grade 2 or higher adverse GI events.
背景/目的：确定与肝脏肿瘤立体定向体部放射治疗（SBRT）相关的胃肠道（GI）不良事件的预测因素。
我们回顾性分析了2016年至2021年间在本机构接受肝脏肿瘤SBRT治疗的56例患者。在线性二次模型（LQ模型）中，胃肠道（胃、十二指肠和大肠）的α/β比值假定为3 Gy。将胃肠道的剂量，即生物等效剂量3（BED3）转换为2 Gy等效剂量（Gy2/3 = 2 Gy等效剂量，α/β = 3）。使用该2 Gy等效剂量，研究2级或更高等级胃肠道不良事件的预测因素。
中位观察期为10个月（0 - 40个月），中位年龄为77岁（范围 = 29 - 93岁）。56例患者中，43例患有肝细胞癌，另外13例患有肝转移瘤。计划靶体积D95%处方（80%等剂量线）的照射剂量为30 - 54 Gy/5 - 18次分割。56例患者中有8例发生2级或更高等级的胃肠道不良事件。单因素分析显示，胃肠道D1cc、Dmax、V20、V25、V30和V35均为二级或更高等级胃肠道不良事件的显著预测因素。其中，胃肠道V35是二级或更高等级胃肠道不良事件的最显著预测因素。
对于肝脏肿瘤的SBRT，胃肠道V35是二级或更高等级胃肠道不良事件的最佳预测因素。
