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Báo cáo khoa học: " Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control. | Stinauer et al. Radiation Oncology 2011 6 34 http www.ro-journal.eom content 6 1 34 RADIATION ONCOLOGY RESEARCH Open Access Stereotactic body radiation therapy for melanoma and renal cell carcinoma impact of single fraction equivalent dose on local control 1 1 1111 Michelle A Stinauer Brian D Kavanagh Tracey E Schefter Rene Gonzalez Thomas Flaig Karl Lewis William Robinson1 Mark Chidel2 Michael Glode1 and David Raben1 Abstract Background Melanoma and renal cell carcinoma RCC are traditionally considered less radioresponsive than other histologies. Whereas stereotactic body radiation therapy SBRT involves radiation dose intensification via escalation we hypothesize SBRT might result in similar high local control rates as previously published on metastases of varying histologies. Methods The records of patients with metastatic melanoma n 17 patients 28 lesions or RCC n 13 patients 25 lesions treated with SBRT were reviewed. Local control LC was defined pathologically by negative biopsy or radiographically by lack of tumor enlargement on CT or stable declining standardized uptake value SUV on PET scan. The SBRT dose regimen was converted to the single fraction equivalent dose SFED to characterize the dosecontrol relationship using a logistic tumor control probability TCP model. Additionally the kinetics of decline in maximum SUV SUVmax were analyzed. Results The SBRT regimen was 40-50 Gy 5 fractions n 23 or 42-60 Gy 3 fractions n 30 delivered to lung n 39 liver n 11 and bone n 3 metastases. Median follow-up for patients alive at the time of analysis was 28.0 months range 4-68 . The actuarial LC was 88 at 18 months. On univariate analysis higher dose per fraction p 0.01 and higher SFED p 0.06 were correlated with better LC as was the biologic effective dose BED p 0.05 . The actuarial rate of LC at 24 months was 100 for SFED 45 Gy v 54 for SFED 45 Gy. TCP modeling indicated that to achieve 90 2 yr LC in a 3 fraction regimen a prescription dose of at least 48 Gy is .