Focal dose escalation using FDG-PET-guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP

被引：22

作者：

Jingu, Keiichi ^{[1
]}

Ariga, Hisanori ^{[1
]}

Kaneta, Tomohiro ^{[2
]}

Takai, Yoshihiro ^{[1
]}

Takeda, Ken ^{[1
]}

Katja, Lindel ^{[4
]}

Narazaki, Kakutaro ^{[1
]}

Metoki, Takahiro ^{[1
]}

Fujimoto, Keisuke ^{[1
]}

Umezawa, Rei ^{[1
]}

Ogawa, Yoshihiro ^{[1
]}

Nemoto, Kenji ^{[3
]}

Koto, Masashi ^{[1
]}

Mitsuya, Masatoshi ^{[1
]}

Matsufuji, Naruhiro ^{[5
]}

Takahashi, Shoki ^{[2
]}

Yamada, Shogo ^{[1
]}

机构：

[1] Tohoku Univ, Sch Med, Dept Radiat Oncol, Sendai, Miyagi 980, Japan

[2] Tohoku Univ, Sch Med, Dept Diagnost Radiol, Sendai, Miyagi 980, Japan

[3] Yamagata Univ, Sch Med, Dept Radiat Oncol, Yamagata 99023, Japan

[4] Heidelberg Univ, Dept Radiooncol, Heidelberg, Germany

[5] Natl Inst Radiol Sci, Dept Accelerator Phys & Engn, Chiba 260, Japan

来源：

BMC CANCER | 2010年 / 10卷

关键词：

POSITRON-EMISSION-TOMOGRAPHY; SQUAMOUS-CELL CARCINOMA; LYMPH-NODE DISSECTION; TUMOR HYPOXIA; SURGICAL SALVAGE; NORMAL TISSUE; HEAD; FLUORODEOXYGLUCOSE; RADIOTHERAPY; CT;

D O I：

10.1186/1471-2407-10-127

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: To evaluate the safety of focal dose escalation to regions with standardized uptake value (SUV) > 2.0 using intensity-modulated radiation therapy (IMRT) by comparison of radiotherapy plans using dose-volume histograms (DVHs) and normal tissue complication probability (NTCP) for postoperative local recurrent rectal cancer Methods: First, we performed conventional radiotherapy with 40 Gy/20 fr. (CRT 40 Gy) for 12 patients with postoperative local recurrent rectal cancer, and then we performed FDG-PET/CT radiotherapy planning for those patients. We defined the regions with SUV > 2.0 as biological target volume (BTV) and made three boost plans for each patient: 1) CRT boost plan, 2) IMRT without dose-painting boost plan, and 3) IMRT with dose-painting boost plan. The total boost dose was 20 Gy. In IMRT with dose-painting boost plan, we increased the dose for BTV+5 mm by 30% of the prescribed dose. We added CRT boost plan to CRT 40 Gy (summed plan 1), IMRT without dose-painting boost plan to CRT 40 Gy (summed plan 2) and IMRT with dose-painting boost plan to CRT 40 Gy (summed plan 3), and we compared those plans using DVHs and NTCP. Results: D-mean of PTV-PET and that of PTV-CT were 26.5 Gy and 21.3 Gy, respectively. V-50 of small bowel PRV in summed plan 1 was significantly higher than those in other plans ((summed plan 1 vs. summed plan 2 vs. summed plan 3: 47.11 +/- 45.33 cm(3) vs. 40.63 +/- 39.13 cm(3) vs. 41.25 +/- 39.96 cm(3)(p < 0.01, respectively)). There were no significant differences in V-30, V-40, V-60, D-mean or NTCP of small bowel PRV. Conclusions: FDG-PET-guided IMRT can facilitate focal dose-escalation to regions with SUV above 2.0 for postoperative local recurrent rectal cancer.

引用

页数：10

共 41 条

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