PDF(Pubmed)
Abstract：
UNASSIGNED: Limited data is available about the feasibility of stereotactic body radiation therapy (SBRT) for treating more than five extra-cranial metastases, and almost no data for treating more than ten. The aim of this study was to investigate the feasibility of SBRT in this polymetatstatic setting.
UNASSIGNED: Consecutive metastatic melanoma patients with more than ten extra-cranial metastases and a maximum lesion diameter below 11 cm were selected from a single-center prospective registry for this in-silico planning study. For each patient, SBRT plans were generated to treat all metastases with a prescribed dose of 5x7Gy, and dose-limiting organs (OARs) were analyzed. A cell-kill based inverse planning approach was used to automatically determine the maximum deliverable dose to each lesion individually, while respecting all OARs constraints.
UNASSIGNED: A total of 23 polymetastatic patients with a medium of 17 metastases (range, 11-51) per patient were selected. SBRT plans with sufficient target coverage and respected OARs dose constraints were achieved in 16 out of 23 patients. In the remaining seven patients, the lungs V5Gy < 80 % and the liver D700 cm3 < 15Gy were most frequently the dose-limiting constraints. The cell-kill based planning approach allowed optimizing the dose administration depending on metastases total volume and location.
UNASSIGNED: This retrospective planning study shows the feasibility of definitive SBRT for 70% of polymetastatic patients with more than ten extra-cranial lesions and proposes the cell-killing planning approach as an approach to individualize treatment planning in polymetastatic patients\'.
UNASSIGNED: Consecutive metastatic melanoma patients with more than ten extra-cranial metastases and a maximum lesion diameter below 11 cm were selected from a single-center prospective registry for this in-silico planning study. For each patient, SBRT plans were generated to treat all metastases with a prescribed dose of 5x7Gy, and dose-limiting organs (OARs) were analyzed. A cell-kill based inverse planning approach was used to automatically determine the maximum deliverable dose to each lesion individually, while respecting all OARs constraints.
UNASSIGNED: A total of 23 polymetastatic patients with a medium of 17 metastases (range, 11-51) per patient were selected. SBRT plans with sufficient target coverage and respected OARs dose constraints were achieved in 16 out of 23 patients. In the remaining seven patients, the lungs V5Gy < 80 % and the liver D700 cm3 < 15Gy were most frequently the dose-limiting constraints. The cell-kill based planning approach allowed optimizing the dose administration depending on metastases total volume and location.
UNASSIGNED: This retrospective planning study shows the feasibility of definitive SBRT for 70% of polymetastatic patients with more than ten extra-cranial lesions and proposes the cell-killing planning approach as an approach to individualize treatment planning in polymetastatic patients\'.
摘要：
■关于立体定向身体放射疗法（SBRT）治疗超过5个脑外转移瘤的可行性的数据有限，几乎没有治疗十多个的数据。这项研究的目的是研究SBRT在这种多静态环境中的可行性。
■从单中心前瞻性登记中选择了连续转移性黑色素瘤患者，这些患者具有10个以上的颅外转移和最大病变直径小于11cm，用于这项计算机规划研究。对于每个病人来说,SBRT计划以5x7Gy的处方剂量治疗所有转移瘤。和剂量限制器官（OARs）进行分析。使用基于细胞杀伤的逆向计划方法来自动确定每个病变的最大可输送剂量。同时尊重所有OAR约束。
■总共23例多转移患者，其中17例转移（范围，选择每位患者11-51）。23名患者中有16名实现了具有足够目标覆盖率和受尊重的OAR剂量限制的SBRT计划。其余7名患者,肺V5Gy<80%和肝D700cm3<15Gy是最常见的剂量限制约束。基于细胞杀伤的计划方法允许根据转移的总体积和位置优化剂量施用。
■这项回顾性计划研究显示了明确的SBRT对70％的多转移性患者有10个以上的颅外病变的可行性，并提出了细胞杀伤计划方法作为一种个性化的方法多转移性患者的治疗计划。
■从单中心前瞻性登记中选择了连续转移性黑色素瘤患者，这些患者具有10个以上的颅外转移和最大病变直径小于11cm，用于这项计算机规划研究。对于每个病人来说,SBRT计划以5x7Gy的处方剂量治疗所有转移瘤。和剂量限制器官（OARs）进行分析。使用基于细胞杀伤的逆向计划方法来自动确定每个病变的最大可输送剂量。同时尊重所有OAR约束。
■总共23例多转移患者，其中17例转移（范围，选择每位患者11-51）。23名患者中有16名实现了具有足够目标覆盖率和受尊重的OAR剂量限制的SBRT计划。其余7名患者,肺V5Gy<80%和肝D700cm3<15Gy是最常见的剂量限制约束。基于细胞杀伤的计划方法允许根据转移的总体积和位置优化剂量施用。
■这项回顾性计划研究显示了明确的SBRT对70％的多转移性患者有10个以上的颅外病变的可行性，并提出了细胞杀伤计划方法作为一种个性化的方法多转移性患者的治疗计划。
