ABSTRACT
Objective The aim of this study was to investigate the dosimetric advantages of Gating in the treatment of prima-ry hepatic cancer with large segmentation. Methods A retrospective analysis of 10 patients with primary liver cancer from August 2017 to November 2018 after interventional therapy was performed using three consecutive phases of end-tidal phase to achieve pa-tient-controlled large-segment radiotherapy. Ten patients underwent 4DCT localization scan,and 10 respiratory phase sequences were reconstructed by respiratory wave-form,and the images were transmitted to the MIM6. 7. 6 workstation. In the MIM workstation, full-time phase maximum density projection(MIP-10),full-time phase average density projection(Mean-10),end-expiration 3 phase maximum density projection(MIP-3) and end-expiration 3 phase average density projection( Mean-3) were generated re-spectively,where MIP was used for target delineation and Mean for dose calculation. The radiotherapy doctor delineated IGTV-10 and IGTV-3 on the MIM workstation,and released CTV-10,CTV-3,PTV-10 and PTV-3 to compare the volume differences of the target area. After the target area was drawn,the image was transmitted from the MIM workstation to the Eclipse treatment planning sys-tem,and the full-time phase plan(Plan-10)with the same conditions and three consecutive phase-phase gating plans(Plan-3) were prepared. The prescriptive dosage was given at 50 Gy/10 f/2weeks. Comparing the HI and CI of the target area,the comparison of organs at risk included: the average dose of liver Dmean,the irradiation volume of liver less than 15Gy,the Dmax of small intestine, the Dmax of colon, the Dmax of stomach, the average dose of the kidney Dmean, the heart Dmax, and the spinal cord Dmax. Results The volume of the target area delineated at the end of expiratory phase was less than that of the target area outlined by the full-time phase in IGTV,CTV and PTV,and the difference was statistically significant(P<0. 05). In the two groups of seven field coplanar lage-segment radiotherapy plans,the 3-phase respiratory gating plan significantly reduced the dose of the organs at risk, and the difference was statistically significant(P<0. 05). At the same time,there was no statistically difference in the HI and CI be-tween of the two groups(P>0. 05). Conclusion The gated target area delineation and planning design of the three consecutive pha-ses of end-tidal phase reduce the volume of IGTV,CTV and PTV target regions compared with the selection of full-time phase,and have obvious advantages in the planned dosimetry. The irradiation dose that threatens the organs is worthy of being promoted and ap-plied in the large-scale radiotherapy of liver cancer.
ABSTRACT
Objective To assess the feasibility, safety and curative effect of permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy for the treatment of non-small cell lung carcinoma (NSCLC) in aged patients. Methods CT-guided permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy was performed in 46 patients with NSCLC, of whom 26 received primary treatment and 20 underwent renewed treatment. During the procedure, ~(125)I seeds were embedded into the tumor in all the patients. Three to five days after the implantation, GP scheme chemotherapy started. GEM (1 000 mg/m~2) was given (intravenously dripping for 30 min.) on the 1st, 8th and 15th day; DDP (30 mg/m~2) was employed on the 1st, 2nd and 3rd day, and recombinant human endostatin (Endostar, 7.5 mg/m~2) was administered (intravenously dripping for 3-4 hours) from the 1st to the 14th day. Every 28 days completed one treatment course. Two months after ~(125)I seed implantation, at this time the patient had received two courses of treatment, the short-term effect and the toxic side-effect were evaluated. Results Two months after the ~(125)I particles were embedded in the tumor, all the 46 cases were able to be evaluate for the curative effect. Of 46 patients, complete relief (CR) was seen in 12, partial relief (PR) in 24, stable (SD) in 6 and progression (PD) in 4, with an effective rate of 78.26%. Of 26 patients in the primary treatment group, CR was obtained in 7, PR in 15, SD in 3 and PD in 1, with an effective rate of 84.6%. Of 20 patients in the renewed treatment group, CR was seen in 5, PR in 9, SD in 3 and PD in 3, with an effective rate of 70.0%. Conclusion Permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy is an effective, safe and feasible treatment for NSCLC in aged patients.
ABSTRACT
0.05).Conclusions The chemotherapeutic embedding radioactive particle 125Ⅰ combined with GP is safe,feasible,and effective to the therapy of senile-inoperable NSCLC.