Particle therapy

粒子疗法
  • 文章类型: Journal Article
    目标:Neskeep®,可吸收的聚乙醇酸垫片,已被开发为垫片放置手术的最佳材料。然而,防止其严重粘连是一个至关重要的问题。因此,我们旨在使用大鼠模型确定Neskeep®的有效抗粘连剂。
    方法:使用60只大鼠进行动物实验,在腹壁上放置Neskeep®。使用了三种类型的抗粘连剂,建立四个亚组:Seprafilm®,INTERCEED®,AdSpray®,只有Neskeep®(对照)组。在术后第7、14和28天处死大鼠以评估Neskeep®周围的粘连水平具有Lauder评分的宏观视觉评估和组织病理学评估以评估粘连程度。
    结果:四组之间在第7天和第14天的劳德评分比例没有显着差异。组织学评估显示在任何观察时间组间没有显著差异。然而,在Neskeep®中,Lauder在第28天的平均得分分别为5.0、1.6、4.0和4.8,Seprafilm®,INTERCEED®,和AdSpray®组,分别。在第28天,Seprafilm®组中温和劳德评分的比例显著较高。
    结论:Seprafilm®与Neskeep®一起使用时可能表现出抗粘附作用。
    OBJECTIVE: Neskeep®, an absorbable polyglycolic acid spacer, has been developed as the optimal material for spacer placement surgery. However, preventing its severe adhesion is a crucial concern. Therefore, we aimed to identify an effective anti-adhesion agent for Neskeep® using rat models.
    METHODS: Animal experiments were performed using 60 rats, which underwent Neskeep® placement on the abdominal wall. Three types of anti-adhesion agents were employed, establishing four subgroups: Seprafilm®, INTERCEED®, AdSpray®, and only Neskeep® (control) groups. Rats were sacrificed on postoperative days 7, 14, and 28 to assess adhesion levels around the Neskeep® Macroscopic visual assessment with the Lauder score and histopathological evaluation were performed to assess the degree of adhesion.
    RESULTS: There were no significant differences in the proportion of Lauder scores on days 7 and 14 between the four groups. Histological evaluation revealed no significant differences between groups at any observation time. However, the mean Lauder scores at day 28 were 5.0, 1.6, 4.0, and 4.8 in the Neskeep®, Seprafilm®, INTERCEED®, and AdSpray® groups, respectively. The proportion of milder Lauder score was significantly higher in the Seprafilm® group on day 28.
    CONCLUSIONS: Seprafilm® may exhibit an anti-adhesive effect when used with Neskeep®.
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  • 文章类型: Journal Article
    目的:&#xD;扫描粒子治疗通常需要复杂的治疗计划,鲁棒优化,以及适应治疗。由于可变的相对生物有效性,计划优化对于重离子尤其复杂。我们提出了一种新颖的深度学习模型,用于在规划过程中选择体素的子集,从而减少规划问题的大小,以提高计算效率。&#xD;方法:&#xD;仅使用目标和危险器官(OAR)中的体素的子集,我们制定了高质量的治疗计划,但是启发式选择策略需要手动输入。我们设计了一个基于P-Net的深度学习模型,以获得最佳的体素采样,而不依赖于患者特定的用户输入。一组70名接受碳离子治疗的头颈部患者用于模型训练(50),验证(10)和测试(10)。为了培训,共优化了12500个碳离子计划,使用在研究治疗计划平台中实施的高效人工智能(AI)基础设施。自定义损失函数增加了剂量不足区域的采样密度,同时旨在减少体素的总数。 主要结果: 在测试数据集上,在计划质量损失中位数<1%时,优化中的体素数量可以减少84.8%(中位数).当模型被训练为仅在将所有体素保持在OAR中的同时减少目标中的采样时,中位数下降高达71.6%,计划质量损失0.5%。对于总AI选择模型,优化时间减少了7.5倍,对于只有目标选择的模型,优化时间减少了3.7倍。&#xD;意义:&#xD;新颖的深度学习体素采样技术实现了计算时间的显着减少,而计划质量的损失可以忽略不计。优化时间的减少对于未来的实时自适应策略尤其有用。 .
    Objective.Scanned particle therapy often requires complex treatment plans, robust optimization, as well as treatment adaptation. Plan optimization is especially complicated for heavy ions due to the variable relative biological effectiveness. We present a novel deep-learning model to select a subset of voxels in the planning process thus reducing the planning problem size for improved computational efficiency.Approach.Using only a subset of the voxels in target and organs at risk (OARs) we produced high-quality treatment plans, but heuristic selection strategies require manual input. We designed a deep-learning model based onP-Net to obtain an optimal voxel sampling without relying on patient-specific user input. A cohort of 70 head and neck patients that received carbon ion therapy was used for model training (50), validation (10) and testing (10). For training, a total of 12 500 carbon ion plans were optimized, using a highly efficient artificial intelligence (AI) infrastructure implemented into a research treatment planning platform. A custom loss function increased sampling density in underdosed regions, while aiming to reduce the total number of voxels.Main results.On the test dataset, the number of voxels in the optimization could be reduced by 84.8% (median) at <1% median loss in plan quality. When the model was trained to reduce sampling in the target only while keeping all voxels in OARs, a median reduction up to 71.6% was achieved, with 0.5% loss in the plan quality. The optimization time was reduced by a factor of 7.5 for the total AI selection model and a factor of 3.7 for the model with only target selection.Significance.The novel deep-learning voxel sampling technique achieves a significant reduction in computational time with a negligible loss in the plan quality. The reduction in optimization time can be especially useful for future real-time adaptation strategies.
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  • 文章类型: Journal Article
    目的:探讨质子和碳离子放疗对可手术的早期肺癌患者的毒性和生存结局。
    方法:这项全国范围的多中心前瞻性队列研究纳入了可手术的早期肺癌患者。质子和碳离子放射治疗按统一治疗政策规定的时间表进行。无进展生存期(PFS),评估总生存期(OS)和治疗相关毒性.
    结果:共纳入274例患者,并纳入疗效和安全性分析。最常见的肿瘤类型是腺癌(44%),而105例(38%)未经组织学证实或临床诊断。总的来说,274例患者中有250例(91%)的肿瘤位于外周,而138例(50%)和136例(50%)患者接受了质子和碳离子放射治疗,分别。所有截尾患者的中位随访时间为42.8个月(IQR36.7-49.0)。在4例(1.5%)中观察到3级或严重的治疗相关毒性。3年PFS为80.5%(95%CI:75.7%-85.5%),OS为92.5%(95%CI:89.3%-95.8%)。病理证实和临床分期是与PFS显著相关的因素,而肿瘤位置和粒子离子类型没有。同时,临床分期与OS显著相关,但是病理证实,肿瘤位置,和粒子离子类型不是。
    结论:颗粒治疗可手术的早期肺癌在每个亚组中都能获得出色的3年OS和PFS。在这种疾病的背景下,质子和碳离子束疗法是治愈性手术的可行替代方案。
    OBJECTIVE: To investigate the toxicity and survival outcomes of proton and carbon ion radiotherapy for patients with operable early-stage lung cancer who are eligible for lobectomy.
    METHODS: This multicenter nationwide prospective cohort study included patients with operable early-stage lung cancer. Proton and carbon ion radiotherapy was performed according to the schedule stipulated in the unified treatment policy. Progression-free survival (PFS), overall survival (OS) and treatment-related toxicities were evaluated.
    RESULTS: A total of 274 patients were enrolled and included in efficacy and safety analyses. The most common tumor type was adenocarcinoma (44 %), while 105 cases (38 %) were not histologically confirmed or diagnosed clinically. Overall, 250 (91 %) of the 274 patients had tumors that were peripherally situated, while 138 (50 %) and 136 (50 %) patients were treated by proton and carbon ion radiotherapy, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7-49.0). Grade 3 or severe treatment-related toxicity was observed in 4 cases (1.5 %). Three-year PFS was 80.5 % (95 % CI: 75.7 %-85.5 %) and OS was 92.5 % (95 % CI: 89.3 %-95.8 %). Pathological confirmation and clinical stage were factors significantly associated with PFS, while tumor location and particle-ion type were not. Meanwhile, clinical stage was significantly associated with OS, but pathological confirmation, tumor location, and particle-ion type were not.
    CONCLUSIONS: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS in each subset. In this disease context, proton and carbon ion beam therapies are feasible alternatives to curative surgery.
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  • 文章类型: Journal Article
    背景:颗粒疗法在肿瘤疾病的治疗中做出了值得注意的贡献。为了能够从不同的角度照射,通常很贵,使用复杂的大型龙门架。而是通过机架旋转光束,病人本身可能会旋转。在这里,我们介绍了志愿者对临床磁共振(MR)扫描仪中全封闭患者旋转系统的耐受性和依从性,可用于MR引导的放射治疗。在一项前瞻性评估研究中进行。
    方法:使用患者旋转系统模拟并执行磁共振成像(MRI)检查,其中50名志愿者没有肿瘤问题。对于20名参与者,通过引入逼真的MRI噪声来模拟孔内的MR检查,而30名参与者接受了图像采集检查。最初,评估了身体参数和幽闭恐惧症。然后将受试者旋转到不同角度进行模拟(0°,45°,90°,180°)和成像(0°,70°,90°,110°)。在每个角度,使用6项状态-特质-焦虑量表(STAI-6)和改良的运动疾病评估问卷(MSAQ)评估焦虑和晕车。此外,评估了不适的一般区域。
    结果:在50名受试者中,3名(6%)受试者提前终止研究。一名受试者在模拟期间因旋转至45°时恶心而退出。在成像过程中,另外两名受试者因肩痛从90°和110°定位而退出,分别。幽闭恐怖症的平均结果(0=无幽闭恐怖症至4=极端幽闭恐怖症)对轻度幽闭恐怖症的平均结果(平均得分:模拟0.64±0.33,成像0.51±0.39)。平均焦虑评分(0%=无焦虑至100%=最大焦虑)为11.04%(模拟)和15.82%(成像)。在所有参与者中获得3.5%(模拟)和6.76%(成像)的平均晕动病评分(0%=无晕动病至100%=最大晕动病)。
    结论:我们的研究证明了在MR扫描仪内全封闭旋转系统中水平旋转的可行性。焦虑评分较低,晕车仅是次要影响。焦虑和晕车都没有角度依赖性。关于旋转装置中的固定的进一步优化可以增加受试者的舒适度。
    BACKGROUND: Particle therapy makes a noteworthy contribution in the treatment of tumor diseases. In order to be able to irradiate from different angles, usually expensive, complex and large gantries are used. Instead rotating the beam via a gantry, the patient itself might be rotated. Here we present tolerance and compliance of volunteers for a fully-enclosed patient rotation system in a clinical magnetic resonance (MR)-scanner for potential use in MR-guided radiotherapy, conducted within a prospective evaluation study.
    METHODS: A patient rotation system was used to simulate and perform magnetic resonance imaging (MRI)-examinations with 50 volunteers without an oncological question. For 20 participants, the MR-examination within the bore was simulated by introducing realistic MRI noise, whereas 30 participants received an examination with image acquisition. Initially, body parameters and claustrophobia were assessed. The subjects were then rotated to different angles for simulation (0°, 45°, 90°, 180°) and imaging (0°, 70°, 90°, 110°). At each angle, anxiety and motion sickness were assessed using a 6-item State-Trait-Anxiety-Inventory (STAI-6) and a modified Motion Sickness Assessment Questionnaire (MSAQ). In addition, general areas of discomfort were evaluated.
    RESULTS: Out of 50 subjects, three (6%) subjects terminated the study prematurely. One subject dropped out during simulation due to nausea while rotating to 45°. During imaging, further two subjects dropped out due to shoulder pain from positioning at 90° and 110°, respectively. The average result for claustrophobia (0 = no claustrophobia to 4 = extreme claustrophobia) was none to light claustrophobia (average score: simulation 0.64 ± 0.33, imaging 0.51 ± 0.39). The mean anxiety scores (0% = no anxiety to 100% = maximal anxiety) were 11.04% (simulation) and 15.82% (imaging). Mean motion sickness scores (0% = no motion sickness to 100% = maximal motion sickness) of 3.5% (simulation) and 6.76% (imaging) were obtained across all participants.
    CONCLUSIONS: Our study proves the feasibility of horizontal rotation in a fully-enclosed rotation system within an MR-scanner. Anxiety scores were low and motion sickness was only a minor influence. Both anxiety and motion sickness showed no angular dependency. Further optimizations with regard to immobilization in the rotation device may increase subject comfort.
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  • 文章类型: Journal Article
    背景:最近的I/II期研究确定了cT1bN0M0食管癌确定性碳离子放疗(CIRT)的最佳剂量。这项研究旨在进一步证实CIRT推荐剂量分级的有效性和可行性,并在更大的样本量中获得长期随访结果。
    方法:这项单中心回顾性研究评估了cT1bN0M0食管鳞状细胞癌患者在12个部分中以50.4Gy的推荐剂量分割治疗,2012年至2022年。
    结果:38例患者在我们医院接受CIRT。尽管有8名(21.1%)患者年龄超过80岁,15人(39.5%)手术风险高,7人(18.4%)化疗风险高,所有患者均按计划接受CIRT。3级食管炎发生在8例(21.1%)患者中,3级肺炎发生在1例(2.6%)患者中。但未发生4级不良事件.唯一的3级晚期不良事件是一名患者的肺炎(2.6%)。5年总生存率,本地控制率,无病生存率为76.6%(95%CI,90.9-62.4),74.9%(95%CI,90.7-59.0),和66.4%(95%CI,83.3-49.5),分别。此外,CI后RT复发如下:7例(18.4%)患者在食管的另一部分复发,三个(7.9%)在主站点,三个(7.9%)在照射区域以外的淋巴结中,1例(2.6%)患者有肝转移。
    结论:我们的研究表明,使用推荐剂量分割的CIRT治疗cT1bN0M0食管鳞状细胞癌是可行且有效的。
    BACKGROUND: A recent phase I/II study determined the optimal dose of definitive carbon-ion radiotherapy (CIRT) for cT1bN0M0 esophageal cancer. This study aimed to further confirm the efficacy and feasibility of the recommended dose fractionation of CIRT with long-term follow-up results in a larger sample size.
    METHODS: This single center retrospective study evaluated patients with cT1bN0M0 esophageal squamous cell carcinoma treated with the recommended dose fractionation of 50.4 Gy relative biological effectiveness in 12 fractions, between 2012 and 2022.
    RESULTS: Thirty-eight patients underwent CIRT at our hospital. Although eight (21.1%) patients were older than 80 years, 15 (39.5%) had high surgical risk, and seven (18.4%) were at high risk for chemotherapy, all patients underwent CIRT as scheduled. Grade 3 esophagitis occurred in eight (21.1%) patients and grade 3 pneumonia in one (2.6%) patient in this study, but no grade 4 adverse events occurred. The only grade 3 late adverse event was pneumonia in one patient (2.6%). The 5-year overall survival rate, local control rate, and disease-free survival rates were 76.6% (95% CI, 90.9-62.4), 74.9% (95% CI, 90.7-59.0), and 66.4% (95% CI, 83.3-49.5), respectively. Additionally, post CIRT recurrence was as follows: seven (18.4%) patients had recurrence in another part of the esophagus, three (7.9%) in the primary site, three (7.9%) in lymph nodes outside the irradiated area, and one (2.6%) patient had liver metastasis.
    CONCLUSIONS: Our study demonstrates that CIRT using the recommended dose fractionation is feasible and effective for cT1bN0M0 esophageal squamous cell carcinoma.
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  • 文章类型: Journal Article
    目的:头颈部腺样囊性癌(HNACC)是一种耐放射性肿瘤。粒子疗法,主要是质子束治疗和碳离子辐射,是一种潜在的放射治疗抗放射性恶性肿瘤。本研究旨在进行荟萃分析,以评估带电粒子放射治疗对HNACC的影响。方法:在Pubmed,科克伦图书馆,WebofScience,Embase,和Medline直到2022年12月31日。主要终点是总生存期(OS),本地控制(LC),和无进展生存期(PFS),而次要结局包括治疗相关毒性.STATA的17.0版用于所有分析。结果:共14项研究,涉及1297名患者,包括在分析中。原发性HNACC的合并5年OS和PFS率为78%(95%置信区间[CI]=66-91%)和62%(95%CI=47-77%),分别。对于所有包括在内的患者,合并的2年和5年操作系统,LC,和PFS率如下:86.1%(95%CI=95-100%)和77%(95%CI=73-82%),92%(95%CI=84-100%)和73%(95%CI=61-85%),76%(95%CI=68-84%)和55%(95%CI=48-62%),分别。3级及以上急性毒性率为22%(95%CI=13-32%),而晚期毒性率为8%(95%CI=3-13%)。结论:颗粒疗法有可能改善HNACC患者的治疗结果并提高其生活质量。然而,由于与这种治疗方式相关的可用性和成本考虑有限,因此需要进一步研究和优化.
    Purpose: Head and neck adenoid cystic carcinoma (HNACC) is a radioresistant tumor. Particle therapy, primarily proton beam therapy and carbon-ion radiation, is a potential radiotherapy treatment for radioresistant malignancies. This study aims to conduct a meta-analysis to evaluate the impact of charged particle radiation therapy on HNACC. Methods: A comprehensive search was conducted in Pubmed, Cochrane Library, Web of Science, Embase, and Medline until December 31, 2022. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), while secondary outcomes included treatment-related toxicity. Version 17.0 of STATA was used for all analyses. Results: A total of 14 studies, involving 1297 patients, were included in the analysis. The pooled 5-year OS and PFS rates for primary HNACC were 78% (95% confidence interval [CI] = 66-91%) and 62% (95% CI = 47-77%), respectively. For all patients included, the pooled 2-year and 5-year OS, LC, and PFS rates were as follows: 86.1% (95% CI = 95-100%) and 77% (95% CI = 73-82%), 92% (95% CI = 84-100%) and 73% (95% CI = 61-85%), and 76% (95% CI = 68-84%) and 55% (95% CI = 48-62%), respectively. The rates of grade 3 and above acute toxicity were 22% (95% CI = 13-32%), while late toxicity rates were 8% (95% CI = 3-13%). Conclusions: Particle therapy has the potential to improve treatment outcomes and raise the quality of life for HNACC patients. However, further research and optimization are needed due to the limited availability and cost considerations associated with this treatment modality.
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  • 文章类型: Journal Article
    近年来,在采用离子放射治疗的不同相对生物有效性(RBE)模型的机构中翻译临床发现的努力迅速增长。然而,即使对于选择的RBE模型,存在不同的实现。这些方法可以考虑或忽略RBE的剂量依赖性和围绕射束轴的辐射质量的径向变化。这项研究调查了在RBE计算过程中忽略这些影响的理论影响。
    使用蒙特卡洛代码PHITS沿1H的扩展布拉格峰进行微剂量模拟,4他,12C,16O,和水幻影中的20Ne离子。RBE是使用梅奥诊所佛罗里达微剂量动力学模型(MCFMKM)和修改后的MKM的不同实现方式计算的,考虑或不考虑离子束半影中辐射质量的径向变化以及RBE的剂量依赖性。
    对于距离目标体积5毫米的OAR,忽略辐射质量的径向变化或RBE的剂量依赖性可能会导致RBE加权剂量的高估,最高可达3.5或1.7。
    接近肿瘤体积的OAR的RBE加权剂量受到RBE计算方法的实质性影响,即使使用相同的RBE模型和细胞系。因此,在使用不同方法的机构之间翻译临床发现时,应注意考虑这些差异。
    UNASSIGNED: The effort to translate clinical findings across institutions employing different relative biological effectiveness (RBE) models of ion radiotherapy has rapidly grown in recent years. Nevertheless, even for a chosen RBE model, different implementations exist. These approaches might consider or disregard the dose-dependence of the RBE and the radial variation of the radiation quality around the beam axis. This study investigated the theoretical impact of disregarding these effects during the RBE calculations.
    UNASSIGNED: Microdosimetric simulations were carried out using the Monte Carlo code PHITS along the spread out Bragg peaks of 1H, 4He, 12C, 16O, and 20Ne ions in a water phantom. The RBE was computed using different implementations of the Mayo Clinic Florida microdosimetric kinetic model (MCF MKM) and the modified MKM, considering or not the radial variation of the radiation quality in the penumbra of the ion beams and the dose-dependence of the RBE.
    UNASSIGNED: For an OAR located 5 mm laterally from the target volume, disregarding the radial variation of the radiation quality or the dose-dependence of the RBE could result in an overestimation of the RBE-weighted dose up to a factor of ∼ 3.5 or ∼ 1.7, respectively.
    UNASSIGNED: The RBE-weighted dose to OARs close to the tumor volume was substantially impacted by the approach employed for the RBE calculations, even when using the same RBE model and cell line. Therefore, care should be taken in considering these differences while translating clinical findings between institutions with dissimilar approaches.
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  • 文章类型: Journal Article
    背景:大范围血管侵犯(MVI)显著影响肝细胞癌(HCC)患者的生存率,保证全身治疗优于局部治疗。尽管方法新颖,与早期至中期HCC相比,MVI的HCC预后较差。本研究旨在评估以MVI为特征的HCC的碳离子放疗(C离子RT)的安全性和有效性。
    方法:这项回顾性队列研究评估了在1995年至2020年期间使用C-离子RT以45.0-48.0Gy/2分或52.8-60.0Gy/4分的剂量治疗MVI的HCC患者。我们分析了预后因素和局部复发率,生存,和不良事件。使用累积发生率函数确定局部复发率,将死亡视为一项竞争事件。使用Kaplan-Meier方法测定存活率。单变量分析的对数秩检验和多变量分析的Cox比例风险模型用于比较亚组。
    结果:总计,76例患者,中位年龄71岁(范围,45-86岁)进行了评估。其中,68人患有Child-PughA级疾病,而8人患有B级疾病。在17名患者中,血管肿瘤血栓到达下腔静脉或门静脉主干。中位随访期为27.9个月(范围,1.5-180.4个月),2年总生存率,无进展生存期,局部复发率为70.0%(95%置信区间[CI]:57.7-79.4%),32.7%(95%CI:22.0-43.8%),和8.9%(95%CI:1.7-23.5%),分别。在单变量分析中,原始肿瘤和单个病变是总生存期的重要预后因素。在多变量分析中,白蛋白-胆红素1级和单个病变是独立的预后因素。总的来说,四名患者(5%)经历了3级晚期不良事件,没有观察到4级或5级急性或晚期不良事件。
    结论:C-离子RT治疗MVI的HCC显示出良好的局部控制和生存益处,毒性最小。
    BACKGROUND: Macroscopic vascular invasion (MVI) significantly impacts survival in patients with hepatocellular carcinoma (HCC), warranting systemic therapy over locoregional therapy. Despite novel approaches, HCC with MVI has a poor prognosis compared to early-to intermediate-stage HCC. This study aimed to evaluate the safety and efficacy of carbon-ion radiotherapy (C-ion RT) for HCC characterized by MVI.
    METHODS: This retrospective cohort study evaluated HCC patients with MVI treated using C-ion RT with a dose of 45.0-48.0 Gy/2 fractions or 52.8-60.0 Gy/4 fractions between 1995 and 2020 at our institution in Japan. We analyzed the prognostic factors and rates of local recurrence, survival, and adverse events. The local recurrence rate was determined using the cumulative incidence function, with death as a competing event. Survival rates were determined using the Kaplan-Meier method. The log-rank test for univariate analysis and the Cox proportional hazards model for multivariate analysis were used to compare subgroups.
    RESULTS: In total, 76 patients with a median age of 71 years (range, 45-86 years) were evaluated. Among them, 68 had Child-Pugh grade A while eight had grade B disease. In 17 patients, the vascular tumor thrombus reached the inferior vena cava or main trunk of the portal vein. Over a median follow-up period of 27.9 months (range, 1.5-180.4 months), the 2-year overall survival, progression-free survival, and local recurrence rates were 70.0% (95% confidence interval [CI]: 57.7-79.4%), 32.7% (95% CI: 22.0-43.8%), and 8.9% (95% CI: 1.7-23.5%), respectively. A naïve tumor and a single lesion were significant prognostic factors for overall survival in the univariate analysis. Albumin-bilirubin grade 1 and a single lesion were independent prognostic factors in the multivariate analysis. Overall, four patients (5%) experienced grade 3 late adverse events, with no observed grade 4 or 5 acute or late adverse events.
    CONCLUSIONS: C-ion RT for HCC with MVI showed favorable local control and survival benefits with minimal toxicity.
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  • 文章类型: Journal Article
    目的:本研究旨在开发具有插件(PSP)的多孔结构,以扩大布拉格峰宽(BPW,定义为碳离子束的近端和远端80%剂量之间的水中距离),同时保持尖锐的远端衰减宽度(DFW,定义为沿光束轴的距离,其中水中的剂量从80%减少到20%)。
    方法:在蒙特卡罗代码FLUKA中建立了多孔结构(PS)和PSP的二元体素模型,并通过3D打印制造了相应的物理模型。进行实验和仿真以评估PS和PSP的调制能力。比较了从每个积分深度剂量曲线得出的BPWs和DFW。通过分析实验中PSP下游六个不同位置的辐射变色膜,记录了通过PSP的430MeV/u碳离子束的通量均匀性。此外,通过改变束斑大小和在PSP上的入射位置,共模拟了48种不同的碳离子束,并评估了相应的束指标偏差,以测试PSP的调制稳定性。
    结果:根据测量数据,与PS相比,PSP的使用导致BPW平均增加0.63mm,DFW平均减少0.74mm。当光束通过≥10cm的PMMA介质时,2D辐射场的不均匀性低于3%。此外,采用≥6mm的光斑尺寸可确保光束度量偏差,包括BPW,DFW,和范围,保持在0.1毫米的偏差在不同的入射位置。
    结论:开发的PSP证明了其有效拓宽碳离子束的BPW的能力,同时与PS相比保持尖锐的DFW。PSP的优越性能,表明其未来临床应用的潜力。
    OBJECTIVE: The present study aimed to develop a porous structure with plug-ins (PSP) to broaden the Bragg peak width (BPW, defined as the distance in water between the proximal and distal 80% dose) of the carbon ion beam while maintaining a sharp distal falloff width (DFW, defined as the distance along the beam axis where the dose in water reduces from 80% to 20%).
    METHODS: The binary voxel models of porous structure (PS) and PSP were established in the Monte Carlo code FLUKA and the corresponding physical models were manufactured by 3D printing. Both experiment and simulation were performed for evaluating the modulation capacity of PS and PSP. BPWs and DFWs derived from each integral depth dose curves were compared. Fluence homogeneity of 430 MeV/u carbon-ion beam passing through the PSP was recorded by analyzing radiochromic films at six different locations downstream the PSP in the experiment. Additionally, by changing the beam spot size and incident position on the PSP, totally 48 different carbon-ion beams were simulated and corresponding deviations of beam metrics were evaluated to test the modulating stability of PSP.
    RESULTS: According to the measurement data, the use of PSP resulted in an average increase of 0.63 mm in BPW and a decrease of 0.74 mm in DFW compared to PS. The 2D radiation field inhomogeneities were lower than 3 % when the beam passing through a ≥ 10 cm PMMA medium. Furthermore, employing a spot size of ≥ 6 mm ensures that beam metric deviations, including BPW, DFW, and range, remain within a deviation of 0.1 mm across various incident positions.
    CONCLUSIONS: The developed PSP demonstrated its capability to effectively broaden the BPW of carbon ion beams while maintaining a sharp DFW comparing to PS. The superior performance of PSP, indicates its potential for clinical use in the future.
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  • 文章类型: Journal Article
    粒子疗法和放射性药物是泌尿生殖系统癌症治疗中的新兴领域。随着这些新技术和不断增长的免疫疗法选择,这些疗法的组合具有提高当前癌症治愈率的潜力。然而,这些疗法最有效的顺序和组合是未知的,并且是多个正在进行的临床试验中正在积极探索的问题.这里,我们回顾了粒子疗法的免疫学效果和可用的放射性药物,并讨论了如何最好地结合这些疗法。
    Particle therapy and radiopharmaceuticals are emerging fields in the treatment of genitourinary cancers. With these novel techniques and the ever-growing immunotherapy options, the combinations of these therapies have the potential to improve current cancer cure rates. However, the most effective sequence and combination of these therapies is unknown and is a question that is actively being explored in multiple ongoing clinical trials. Here, we review the immunological effects of particle therapy and the available radiopharmaceuticals and discuss how best to combine these therapies.
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