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1.
Chinese Journal of Radiation Oncology ; (6): 876-881, 2021.
Article in Chinese | WPRIM | ID: wpr-910485

ABSTRACT

Objective:To compare the dosimetric parameters and plan complexity between newly-delicated HyperArc (HA) and conventional volumetric-modulated arc therapy (VMAT) in the treatment of brain metastases.Methods:For 26 patients with brain metastases, HA, conventional coplanar (Cop) and non-coplanar (Non-cop) VMAT plans with a prescription dose of 9 Gy 3fx or 6 Gy 5fx were generated. The dosimetric parameters for planning target volume (PTV), RTOG conformity index (RTOG CI), Paddick CI, homogeneity index (HI), gradient index (GI), maximum dose (D max) of brainstem and dose-volume parameters of brain-PTV(V 2Gy-V 26Gy) were statisticaly compared among these three approaches. In addition, the monitor unit (MU) and the plan complexity parameters (including MCSv and AlPO) were statistically compared. Results:To prevent missed targets during treatment, all plans were established with RTOG CI of greater than 1.1. For Paddick CI, HA provided significantly higher conformity (0.89±0.019) than Non-cop (0.87±0.036, P=0.001) and Cop (0.88±0.017, P=0.003) VMAT. For GI, the fastest dose fall-off was noted in HA (3.35±0.64), followed by conventional Non-cop VMAT of (3.70±0.80), and conventional Cop VMAT of (4.90±1.85)(all P<0.05). For the brainstem sparing, HA plan performed better than Non-cop plan[(604.14±531.61) cGy vs.(682.75±558.22) cGy, P<0.05)]. For normal brain tissue sparing, HA approach showed significant reduction than conventional Cop and Non-cop VMAT (both P<0.05). For MU, HA approach (2 872.60 ± 566.93) was significantly lower than those of Non-cop VMAT (3 771.28 ± 1 022.38, P<0.05) and Cop VMAT (4 494.08 ± 1 323.09, P<0.05). In terms of plan complexity, the MCSv of Cop plan was the lowest, indicating that the complexity was the highest ( P<0.05). The AlPO of HA was significantly higher than that of Non-cop VMAT ( P<0.05), suggesting that the complexity of HA plan was lower ( P<0.05). Conclusion:For the treatment of brain metastases, HA provides better conformity, more rapid dose fall-off, better sparing of brainstem and normal brain tissues and less plan complexity compared with conventional VMAT.

2.
Chinese Journal of Radiation Oncology ; (6): 467-471, 2019.
Article in Chinese | WPRIM | ID: wpr-755052

ABSTRACT

Brain metastasis is common in non-small-cell lung cancer (NSCLC) with driver gene mutations.At present,brain radiotherapy combined with tyrosine kinase inhibitor (TKI) is a hot topic.Anaplastic lymphoma kinase (ALK) gene rearrangement is one of the common driver mutations in NSCLC.However,the treatment of brain metastasis from NSCLC with ALK gene rearrangement has been rarely investigated.The prognosis of these patients,the role of brain radiotherapy and the proper comb ination of radiotherapy with ALK-TKI are worthy of further exploration.

3.
Chinese Journal of Radiation Oncology ; (6): 132-134, 2018.
Article in Chinese | WPRIM | ID: wpr-708153

ABSTRACT

Objective To analyze the clinical efficacy of gamma-ray fractionated stereotactic radiotherapy (FSRT) in the treatment of intracranial metastatic polycystic tumors.Methods Forty cases with 61 metastatic polycystic tumors were selected from 189 patients with 373 intracranial metastatic tumors admitted to our hospital from 2013 to 2015.All cases received gamma-ray FSRT.The isodose line at 50% was defined as the prescription dose.The prescription dose was ranged from 40 to 48 Gy/10-12f.The survival rate was calculated by Kaplan-Meier method.The single factor analysis was performed by Log-rank method.Results The median follow-up time was 21months (range:6-39 months).The median survival time was 15.3 months.The 6-month,1-and 2-year local control rate was 93%,82% and 79%,respectively.The 1-and 2-year survival rate was 63% and 30%.Single factor analysis demonstrated that the volume of cysts and the volume of lesions were not significantly correlated with local control rate (P=0.17 and 0.48).Conclusion Gamma-ray FSRT can be adopted to treat intracranial metastatic polycystic tumors,which yields similar clinical efficacy to metastatic solid tumors.It deserves wide application in clinical practice due to high local control rate and safety.

4.
Chinese Journal of Radiation Oncology ; (6)1992.
Article in Chinese | WPRIM | ID: wpr-551471

ABSTRACT

Purpose: To report the treatment result for lung cancer with brain metastasis. Materials and Methods: 117 patients with brain metastases from lung cancers were treated by radiotherapy alone or surgery followed by radiotherapy from January, 1987 to December, 1993. Radiotherapy were given with the dose of 23~40Gy (whole brain irradiation) then followed with 15~24Gy booster. Results: The median survival period and one year survival rate were 9.5 months and 62.5% in surgery plus radiotherapy group and 5.7 months and 14.2% in radiotherapy alone group(P

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