Queensland University of Technology, Faculty of Health, School of Clinical Sciences, Brisbane, Queensland, Australia.
Radiation Oncology Princess Alexandra Hospital, Brisbane, Queensland, Australia.
J Med Radiat Sci. 2024 Mar;71(1):156-162. doi: 10.1002/jmrs.714. Epub 2023 Aug 16.
The indications for liver stereotactic body radiation therapy (SBRT) continue to expand in the management of liver cancer due to the improved rates of local control with acceptable normal tissue toxicity. Changes in internal anatomy, such as the bowel, may negatively impact the precision of treatment delivery of SBRT liver treatment by influencing daily image matching. Institutions have developed various approaches to promoting bowel volume consistency. One such strategy is the administration of pharmaceuticals. The administration of pharmaceuticals, such as Simethicone, has been adopted by the Princess Alexandra Hospital Radiation Oncology Department (ROPAIR) as a method to promote consistency in the amount of bowel gas observed in liver cancer patients. This case series examines a group of patients treated at ROPAIR with liver SBRT to determine whether current practices effectively reduce the impact of bowel volume variations for liver cancer patients. Initial observations from this hypothesis generating research suggest potential improved consistency of the small bowel's anatomical position for liver SBRT patients who were administered Simethicone (Bowel bag dice similarity coefficient - Simethicone group = 0.79-0.92, Standard group = 0.24-0.93). However, it appeared that this strategy alone may not be entirely effective achieving consistency in the amount of bowel gas present throughout the duration of treatment. Further investigation into the refinement of liver SBRT pre-treatment preparation is therefore recommended.
肝脏立体定向体部放射治疗（SBRT）的适应证在肝癌治疗中的不断扩大，是由于局部控制率的提高，同时正常组织毒性可接受。由于肠道等内部解剖结构的变化可能会通过影响每日图像匹配来影响 SBRT 肝脏治疗的精确性，从而对治疗输送产生负面影响。各机构已经开发出各种方法来促进肠道体积的一致性。其中一种策略是使用药物。Princess Alexandra Hospital 放射肿瘤学系（ROPAIR）采用了一种名为二甲硅油的药物来促进肝癌患者肠道气体量的一致性。本病例系列研究了一组在 ROPAIR 接受 SBRT 治疗的肝癌患者，以确定当前的实践是否能有效地减少肠道体积变化对肝癌患者的影响。这项假设产生研究的初步观察结果表明，对于接受二甲硅油治疗的 SBRT 患者，其小肠解剖位置的一致性可能会有所提高（肠袋骰子相似系数-二甲硅油组=0.79-0.92，标准组=0.24-0.93）。然而，似乎仅采用这种策略可能无法完全有效地实现在整个治疗过程中保持肠道气体量的一致性。因此，建议进一步研究改进肝脏 SBRT 治疗前的准备工作。
