Alternative Title原発性肺癌に対する肺葉特異性選択的予防的リンパ節領域照射を加えた体幹部定位照射の実現可能性に関する放射線量的評価
Periodical titleJournal of Radiation Research
Note (General)doctoral
医学系研究科
More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3+4+11 for the right upper lobe tumors, LNS 7+11 for the right middle or lower lobe tumors, LNS 5+11 for the left upper lobe tumors, and LNS 7+11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V 20 of the lung, D 1㎤ of the spinal cord, D 1㎤ and D 10㎤ of the esophagus and D 10㎤ of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤ 2.0cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0cm, SBRT with selective ENI may therefore dosimetrically feasible.
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2017-09-02T15:28:24+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション