MR引导的超大分割放疗治疗早期声门型喉癌：一项I期可行性研究
MR-guided ultra-hypofractionated radiotherapy for early-stage glottic cancer: A phase I feasibility study.
文献信息
| PMID | 42835259 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2027 |
| 作者 | S M L Linden |
| 作者单位 | Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands. |
| 期刊 | Clinical and translational radiation oncology |
| SCI 分区 | Q1 |
| IF | 3.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
引言： 早期声门型喉癌的超大分割放疗可减少就诊次数，但需要精确照射以最小化放射性毒性风险。磁共振（MR）引导放疗是一种在每个治疗分次中能够可视化肿瘤和喉软骨的照射技术。此外，运动管理可确保放疗精确递送至肿瘤，同时最小化喉软骨的剂量。本研究评估MR引导的超大分割治疗早期声门型喉癌的可行性和安全性。
研究设计： 这是一项在乌得勒支大学医学中心（UMC Utrecht）开展的前瞻性、单中心I期可行性研究。将纳入20例cT1-2N0M0声门型喉鳞状细胞癌且有根治性放疗指征的患者。活动性吸烟者和不符合剂量标准的患者将被排除。患者接受5次×8.5 Gy，分布在三周内（每周2次）。GTV-PTV边界为前后2 mm、左右2 mm、头尾4 mm。治疗在1.5 T MR-Linac（Elekta Unity）上进行，采用在线计划自适应和运动管理。
终点： 主要终点是技术可行性和安全性。如果至少80%的患者（16/20例）成功在MR-Linac上完成全部五次治疗分次，则认为MR引导的超大分割放疗可行。如果最多10%的患者（2/20例）出现3级无病生存期晚期毒性，则认为治疗安全。
英文摘要
INTRODUCTION: Ultra-hypofractionation for early-stage glottic cancer reduces the number of hospital visits, but requires precise delivery to minimize the risk of radiation-induced toxicity. Magnetic Resonance (MR)-guided radiotherapy is a delivery technique that enables visualization of the tumor and laryngeal cartilages at each treatment session. In addition, motion management provides confidence that radiation is delivered precisely to the tumor while minimizing dose to the laryngeal cartilages. This study evaluates the feasibility and safety of an MR-guided ultra-hypofractionated treatment for early-stage glottic cancer.
STUDY DESIGN: This is a prospective, single-center phase I feasibility study conducted at the University Medical Center (UMC) Utrecht. Twenty patients with cT1-2N0M0 squamous cell carcinoma of the glottic larynx and an indication for definitive radiotherapy will be enrolled. Active smokers and patients who do not meet the dose criteria will be excluded from the study. Patients receive 5 × 8.5 Gy, divided over three weeks (2 fractions per week). The GTV-PTV margin is 2 mm anterior-posterior, 2 mm left-right, and 4 mm cranio-caudal. The treatment is delivered on a 1.5 T MR-Linac (Elekta Unity), using online plan adaptation and motion management.
ENDPOINTS: The primary endpoints are technical feasibility and safety. MR-guided ultra-hypofractionated radiotherapy will be considered feasible if at least 80% of the patients (16/20 patients) successfully complete all five treatment fractions on the MR-Linac. The treatment is considered safe if a maximum of 10% of the patients (2/20 patients) experience a grade 3 disease-free late toxicity.