A dosimetric treatment planning strategy in radioembolization of hepatocarcinoma with 90Y glass microspheres.

医学 毒性 肝细胞癌 剂量学 核医学 薄壁组织 体素 放射治疗计划 基础(医学) 玻璃微球 相伴的 肝功能 微球 放射科 放射治疗 内科学 病理 工程类 胰岛素 化学工程
作者
Carlo Chiesa,Marta Mira-Aladrén,Marco Maccauro,Raffaele Romito,Carlo Spreafico,Carlo Sposito,Sherrie Bhoori,Carlo Morosi,S Pellizzari,A. Negri,Enrico Civelli,Rodolfo Lanocita,Tiziana Camerini,Chiara Bampo,M. Carrara,Ettore Seregni,Alfonso Marchianò,Vincenzo Mazzaferro,Emilio Bombardieri
出处
期刊:PubMed 卷期号:56 (6): 503-8 被引量:71
链接
标识
摘要

Our goal was to limit liver toxicity and to obtain good efficacy by developing a dosimetric treatment planning strategy. While several dosimetric evaluations are reported in literature, the main problem of the safety of the treatment is rarely addressed. Our work is the first proposal of a treatment planning method for glass spheres, including both liver toxicity and efficacy issues.Fifty-two patients (series 1) had been treated for intermediated/advanced hepatocellular carcinoma (HCC) with glass spheres, according to the Therasphere® prescription of 120 Gy averaged on the injected lobe. They were retrospectively evaluated with voxel dosimetry, adopting the local deposition hypothesis. Regions of interest on tumor and non tumor parenchyma were drawn to determine the parenchyma absorbed dose, averaged also on non irradiated voxels, excluding tumor voxels. The relationship between the mean non tumoral parenchyma absorbed dose D and observed liver decompensation was analyzed.Basal Child-Pugh strongly affected the toxicity incidence, which was 22% for A5, 57% for A6, 89% for B7 patients. Restricting the analysis to our numerically richest class (basal Child-Pugh A5 patients), D median values were significantly different between toxic (median 90 Gy) and non toxic treatments (median 58 Gy) at a Mann-Withney test, (P=0.033). Using D as a marker for toxicity, the separation of the two populations in terms of area under ROC curve was 0.75, with 95% C.I. of [0.55-0.95]. The experimental Normal Tissue Complication Probability (NTCP) curve as a function of D resulted in the following values: 0%, 14%, 40%, 67% for D interval of [0-35] Gy, [35-70] Gy, [70-105] Gy, [105-140] Gy.A limit of about 70 Gy for the mean absorbed dose to parenchyma was assumed for A5 patients, corresponding to a 14% risk of liver decompensation. This result is applicable only to our administration conditions: glass spheres after a decay interval of 3.75 days. Different safety limit (40 Gy) are published for resin spheres, characterized by higher number of particle per GBq (more uniform irradiation, bigger biological effect for the same absorbed dose).As result of this study we suggest a constraint of about 70 Gy mean absorbed dose to liver non tumoral parenchyma, corresponding to about 15% probability of radioinduced liver decompensation while still aiming at achieving an absorbed of several hundreds of Gy to lesions.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
XunlongJi完成签到,获得积分20
刚刚
1秒前
爱吃泡芙完成签到,获得积分10
1秒前
椿上春树发布了新的文献求助10
1秒前
2秒前
现代的擎苍完成签到,获得积分10
2秒前
Cai发布了新的文献求助10
2秒前
鹿芩发布了新的文献求助10
3秒前
英姑应助lifeboast采纳,获得10
3秒前
思源应助小黄采纳,获得10
3秒前
高兴纸鹤完成签到,获得积分10
3秒前
搞不动科研完成签到,获得积分10
3秒前
wyw123完成签到,获得积分10
3秒前
快乐的柚子完成签到,获得积分10
5秒前
从容的念真完成签到,获得积分10
5秒前
嗯很好完成签到,获得积分20
5秒前
机械腾发布了新的文献求助10
5秒前
Cymatics发布了新的文献求助10
5秒前
舒服的吗喽完成签到 ,获得积分20
5秒前
无敌小汐发布了新的文献求助10
5秒前
大气指甲油完成签到,获得积分10
6秒前
membrane应助成就曼安采纳,获得10
6秒前
开心千青完成签到,获得积分10
7秒前
犹豫的踏歌完成签到,获得积分10
7秒前
fannyeast完成签到,获得积分10
7秒前
椿上春树完成签到,获得积分10
7秒前
sb发布了新的文献求助10
7秒前
LionontheMars完成签到,获得积分10
8秒前
Tina完成签到 ,获得积分10
8秒前
思源应助niuyangyang采纳,获得10
8秒前
愉快的宛儿完成签到,获得积分10
8秒前
江江完成签到,获得积分10
8秒前
May发布了新的文献求助10
9秒前
尘缘完成签到,获得积分10
9秒前
如此纠结完成签到,获得积分10
9秒前
专一的新之完成签到 ,获得积分10
10秒前
彬墩墩完成签到,获得积分10
10秒前
10秒前
大模型应助ling采纳,获得30
11秒前
linxi完成签到,获得积分10
11秒前
高分求助中
Licensing Deals in Pharmaceuticals 2019-2024 3000
Effect of reactor temperature on FCC yield 2000
Very-high-order BVD Schemes Using β-variable THINC Method 1020
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
Mission to Mao: Us Intelligence and the Chinese Communists in World War II 600
The Conscience of the Party: Hu Yaobang, China’s Communist Reformer 600
Geochemistry, 2nd Edition 地球化学经典教科书第二版,不要epub版本 431
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3298999
求助须知:如何正确求助?哪些是违规求助? 2934058
关于积分的说明 8466290
捐赠科研通 2607414
什么是DOI,文献DOI怎么找? 1423664
科研通“疑难数据库(出版商)”最低求助积分说明 661661
邀请新用户注册赠送积分活动 645286