UNASSIGNED: All patients who received hyperfractionated, accelerated PBR re-RT to the pelvis from 2007 to 2017 were identified. Re-RT was delivered twice daily with a 6 h minimum interfraction interval at 1.5 Gray Relative Biological Effectiveness (Gy(RBE)) per fraction to a total dose of 39-45 Gy(RBE). Concurrent chemotherapy was given to all patients. Comparison photon plans were generated for dosimetric analysis. Dosimetric parameters compared using a matched-pair analysis and the Wilcoxon signed-rank test. Survival analysis was performed Kaplan Meier curves.
UNASSIGNED: Fifteen patients were identified, with a median prior pelvic RT dose of 50.4 Gy (range 25-80 Gy). Median time between the initial RT and PBRT re-RT was 4.7 years (range 1.0-36.1 years). In comparison to corresponding photon re-RT plans, PBR re-RT plans had lower mean PBM dose, and lower volume of PBM getting 5 Gy, 10 Gy, 20 Gy, and 30 Gy (p < 0.001, p < 0.001, p < 0.001, and p = 0.033, respectively).With median 13.9 months follow-up after PBR re-RT, five patients had developed local recurrences, and four patients had developed distant metastases. One-year overall survival following PBR re-RT was 67.5% and one-year progression free survival was 58.7%. No patients developed acute or late Grade 4 toxicity.
UNASSIGNED: PBR re-RT affords improved sparing of PBM compared with photon-based re-RT. Clinically, PBR re-RT is well-tolerated. However, given modest control rates with definitive re-RT without subsequent surgical resection, a multidisciplinary approach should be favored in this setting when feasible.
■所有接受超分割的患者,确定了2007年至2017年骨盆的加速PBR再RT。每天两次递送Re-RT,以每分份1.5Gy相对生物有效性(Gy(RBE))的最小间隔6小时,达到39-45Gy(RBE)的总剂量。所有患者均给予同期化疗。生成比较光子计划用于剂量测定分析。使用配对分析和Wilcoxon符号秩检验比较剂量学参数。采用KaplanMeier曲线进行生存分析。
■确定了15名患者,前盆腔RT剂量中位数为50.4Gy(范围25-80Gy)。初始RT和PBRT再RT之间的中位时间为4.7年(范围为1.0-36.1年)。与相应的光子重RT计划相比,PBR再RT计划的平均PBM剂量较低,和较低的PBM体积得到5Gy,10Gy,20Gy,和30Gy(分别为p<0.001、p<0.001、p<0.001和p=0.033)。PBR再RT后的中位随访时间为13.9个月,五名患者出现局部复发,4例患者发生远处转移。PBR再RT后一年总生存率为67.5%,一年无进展生存率为58.7%。无患者出现急性或晚期4级毒性。
■与基于光子的re-RT相比,PBRre-RT提供了改进的PBM备用。临床上,PBR再RT耐受性良好。然而,考虑到适度的控制率和明确的再RT,没有随后的手术切除,在可行的情况下,应在这种情况下采用多学科方法。