北京中科白殿疯医院在哪 https://baike.baidu.com/item/%E5%88%98%E4%BA%91%E6%B6%9B/21900249?fr=aladdin
摘要
背景：食管癌的新辅助放化疗（nCRT）在治疗过程中导致肿瘤消退。肿瘤消退可以诱导胸腔解剖结构的变化，从而导致较小的目标体积和肿瘤周围处于危险状态的器官（OAR）移位。根据治疗期间的体积变化调整放疗计划可能会减少对OAR的辐射剂量，同时保持足够的目标覆盖率。缺乏有关体积变化幅度及其对胸腔解剖结构影响的数据。这项研究的目的是基于每周MRI扫描评估食管癌nCRT期间原发肿瘤的体积变化。方法：在这项前瞻性研究中，食管腺癌或鳞状细胞癌患者接受了新辅助化学放化疗根据CROSS方案（卡铂紫杉醇23×1.8Gy）包括在内。在每位患者中，进行了六次连续MRI扫描：在nCRT之前进行一次扫描，在nCRT期间每隔一周进行五次。由两名放射肿瘤学家在横切的T2加权图像上描绘了肿瘤体积。结果使用线性混合效应模型分析了体积变化。结果：包括来自29位个体的例MRI扫描。基线时的平均（±标准偏差（SD））肿瘤体积为45cm3（±23）。在nCRT的第一周后开始肿瘤体积消退，随后每隔一周肿瘤体积显着减少。在nCRT的第二周，第三周，第四周和第五周分别观察到分别减少到42cm3（初始体积的91％），38cm3（81％），35cm3（77％）和32cm3（72％）。结论：基于食管癌在nCRT期间每周进行MRI扫描，在治疗过程中观察到肿瘤体积明显减少。体积消退和随之而来的解剖学改变提示适应性放疗的可能益处。
ActaOncol.May13;1-7.doi:10./X...Onlineaheadofprint.
TumorVolumeRegressionDuringNeoadjuvantChemoradiotherapyforEsophagealCancer:AProspectiveStudyWithWeeklyMRIIngmarLDefize12,MickRBoekhoff1,AliciaSBorggreve12,AstridLHMWvanLier1,NoriyoshiTakahashi13,NadiaHajMohammad4,JellePRuurda2,RichardvanHillegersberg2,StellaMook1,GertJMeijer1
PMID:
DOI:10./X..
IF:3.3
Abstract
Background:Neoadjuvantchemoradiotherapy(nCRT)foresophagealcancercausestumorregressionduringtreatment.Tumorregressioncaninducechangesinthethoracicanatomy,withsmallertargetvolumesanddisplacementoforgansatrisk(OARs)surroundingthetumorasaresult.AdaptationoftheradiotherapytreatmentplanaccordingtovolumetricchangesduringtreatmentmightreduceradiationdosetotheOARs,whilemaintainingadequatetargetcoverage.Dataonthemagnitudeofthevolumetricchangesanditsimpactonthethoracicanatomyisscarce.TheaimofthisstudywastoassessthevolumetricchangesintheprimarytumorduringnCRTforesophagealcancerbasedonweeklyMRIscans.
Materialandmethods:Inthisprospectivestudy,patientswithadeno-orsquamouscellcarcinomaoftheesophagustreatedwithneoajduvantchemoradiotherapyaccordingtotheCROSSregimen(carboplatin+paclitaxel+23×1.8Gy)wereincluded.Ofeachpatient,sixsequentialMRIscanswereacquired:onepriortonCRT,andfiveineachsubsequentweekduringnCRT.TumorvolumesweredelineatedonthetransversalT2weightedimagesbytworadiationoncologists.Volumetricchangeswereanalyzedusinglinearmixedeffectsmodels.
Results:AtotalofMRIscansfrom29individualpatientswereincluded.Themean(±standarddeviation(SD))tumorvolumeatbaselinewas45cm3(±23).TumorvolumeregressionstartedafterthefirstweekofnCRTwithasignificantdecreaseintumorvolumeseverysubsequentweek.Adecreaseto42cm3(91%ofinitialvolume),38cm3(81%),35cm3(77%),and32cm3(72%)wasobservedinthesecond,third,fourthandfifthweekofnCRT,respectively.
Conclusion:BasedonweeklyMRIscanningduringnCRTforesophagealcancer,aconsiderabledecreaseintumorvolumewasobservedduringtreatment.Volumeregressionandconsequentialanatomicalchangessuggestthepossiblebenefitofadaptiveradiotherapy.
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