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Abstract：
This study evaluated the efficiency of stereotactic body radiation therapy of lung (SBRT-Lung) in generating a treatment volume using conventional multiple-phase three-dimensional computed tomography (3D-CT) of a patient immobilized with pneumatic abdominal compression. The institutional protocol for SBRT-Lung using the RapidArc technique relied on a planning target volume (PTV) delineated using 3D-CT and accounted for linear and angular displacement of the tumor during respiratory movements. The efficiency of the institutional protocol was compared with that of a conventional method for PTV delineation based on radiobiological estimates, such as tumor control probability (TCP) and normal tissue complication probability (NTCP), evaluated using dose-volume parameters. Pneumatic abdominal compression improved the TCP by 15%. This novel protocol improved the TCP by 0.5% but reduced the NTCP for lung pneumonitis (0.2%) and rib fracture (1.0%). Beyond the observed variations in the patient\'s treatment setup, the institutional protocol yielded a significantly consistent TCP (p < 0.005). The successful clinical outcome of this case study corroborates predictions based on radiobiological evaluation and deserves validation through an increased number of patients.
摘要：
这项研究评估了立体定向全身放射治疗（SBRT-Lung）在使用常规多相三维计算机断层扫描（3D-CT）对气动腹部压迫固定的患者产生治疗体积的效率。使用RapidArc技术的SBRT-Lung的机构协议依赖于使用3D-CT描绘的计划目标体积（PTV），并考虑了呼吸运动期间肿瘤的线性和角位移。将机构协议的效率与基于放射生物学估计的常规PTV划定方法的效率进行了比较，如肿瘤控制概率（TCP）和正常组织并发症概率（NTCP），使用剂量-体积参数进行评估。气动腹部压迫使TCP提高了15%。这种新方案使TCP提高了0.5％，但降低了NTCP的肺肺炎（0.2％）和肋骨骨折（1.0％）。除了观察到的患者治疗设置的变化，机构协议产生了显著一致的TCP(p<0.005)。该病例研究的成功临床结果证实了基于放射生物学评估的预测，值得通过增加患者数量来验证。
