Linac-Based Fractionated Stereotactic Radiotherapy with a Micro-Multileaf Collimator for Brainstem Metastasis.

• 資料種別: 博士論文
• タイトル: Linac-Based Fractionated Stereotactic Radiotherapy with a Micro-Multileaf Collimator for Brainstem Metastasis.
• 著者・編者: Sugimoto, Tadashi; Matsuda, Ryosuke; Tamamoto, Tetsuro; Hontsu, Shigeto; Yamaki, Kaori; Miura, Sachiko; Park, Young-Su; Nakase, Hiroyuki; Hasegawa, Masatoshi
• 著者標目: Sugimoto, Tadashi; Matsuda, Ryosuke; Tamamoto, Tetsuro; Hontsu, Shigeto; Yamaki, Kaori; Miura, Sachiko; Park, Young-Su; Nakase, Hiroyuki; Hasegawa, Masatoshi
• 出版事項: Elsevier
• 出版年月日等: 2019-12
• 出版年（W3CDTF）: 2019-12
• 並列タイトル等: 脳幹部転移性脳腫瘍に対する寡分割定位放射線治療の治療成績
• タイトル（掲載誌）: World neurosurgery
• 巻号年月日等（掲載誌）: 132
• 掲載巻: 132
• 掲載ページ: e680-e686
• ISSN（掲載誌）: ISSN : 1878-8750
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2020-03-16
• 報告番号: 乙第1450号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Brainstem metastasis; Fractionated radiotherapy; Novalis; Stereotactic radiotherapy
• 対象利用者: 一般
• 一般注記: type:Thesis; Background: To assess the neuroimaging and clinical outcomes in patients with brainstem metastasis (BSM) treated with linac-based fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator. Methods: Between May 2007 and January 2017, 24 patients (15 male and 9 female) with BSM (25 lesions: midbrain, 10; pons, 13; and medulla oblongata, 2) were consecutively treated with linac-based fSRT. BSM originated from the lung (n = 18, 75.0%), colon (n = 3, 12.5%), and breast (n = 3, 12.5%). The median patient age was 67.0 (range: 42-80) years. Recursive partition analysis classified 2 patients as class I, 17 as class II, and 5 as class III. Overall survival was calculated using the Kaplan-Meier method. Results: Tumor volume ranged from 0.01 to 7.49 cm3 (median: 0.233 cm3), and patients were treated with a dose of 24-40 Gy in 7-13 fractions. The median OS was 9 months after fSRT (95% confidence interval 4.104-13.896). Large tumor volume, presence of brainstem-related symptoms, poor pretreatment Karnofsky performance status, and recursive partition analysis class III were significantly associated with low overall survival. Tumor volume decreased in 18 metastatic lesions, remained stable in 6, and increased in 1. No patient exhibited permanent radiation injury. Grade 2 nausea and vomiting according to the Common Terminology Criteria for Adverse Events 4.0 occurred in 1 patient who received corticosteroids. Conclusions: Linac-based fSRT with a micro-multileaf collimator delivered in the doses of 24-40 Gy in 7-13 fractions is a safe and effective local therapy for patients with BSM.; 博士（医学）・乙第1450号・令和2年3月16日; Copyright © 2019 Elsevier Inc. All rights reserved.; identifier:World neurosurgery Vol.132 p.e680-e686 (2019 Dec); identifier:18788750; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3740; identifier:World neurosurgery, 132: e680-e686
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1016/j.wneu.2019.08.049
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3740/1/01%e4%b9%991450%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3740/2/02%e4%b9%991450%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3740/3/03%e4%b9%991450%e6%9c%ac%e6%96%87.pdf fulltext