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首页> 美国卫生研究院文献>Journal of Radiation Research >Clinical oxygen enhancement ratio of tumors in carbon ion radiotherapy: the influence of local oxygenation changes
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Clinical oxygen enhancement ratio of tumors in carbon ion radiotherapy: the influence of local oxygenation changes

机译：碳离子放射治疗中肿瘤的临床增氧率：局部氧合变化的影响

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The effect of carbon ion radiotherapy on hypoxic tumors has recently been questioned because of low linear energy transfer (LET) values in the spread-out Bragg peak (SOBP). The aim of this study was to investigate the role of hypoxia and local oxygenation changes (LOCs) in fractionated carbon ion radiotherapy. Three-dimensional tumors with hypoxic subvolumes were simulated assuming interfraction LOCs. Different fractionations were applied using a clinically relevant treatment plan with a known LET distribution. The surviving fraction was calculated, taking oxygen tension, dose and LET into account, using the repairable–conditionally repairable (RCR) damage model with parameters for human salivary gland tumor cells. The clinical oxygen enhancement ratio (OER) was defined as the ratio of doses required for a tumor control probability of 50% for hypoxic and well-oxygenated tumors. The resulting OER was well above unity for all fractionations. For the hypoxic tumor, the tumor control probability was considerably higher if LOCs were assumed, rather than static oxygenation. The beneficial effect of LOCs increased with the number of fractions. However, for very low fraction doses, the improvement related to LOCs did not compensate for the increase in total dose required for tumor control. In conclusion, our results suggest that hypoxia can influence the outcome of carbon ion radiotherapy because of the non-negligible oxygen effect at the low LETs in the SOBP. However, if LOCs occur, a relatively high level of tumor control probability is achievable with a large range of fractionation schedules for tumors with hypoxic subvolumes, but both hyperfractionation and hypofractionation should be pursued with caution.
机译：碳离子放射疗法对低氧性肿瘤的效果最近受到质疑，因为扩展的布拉格峰（SOBP）中的线性能量转移（LET）值较低。这项研究的目的是调查缺氧和局部氧合变化（LOCs）在分级碳离子放射治疗中的作用。假设间断LOC，模拟了具有低氧亚体积的三维肿瘤。使用具有已知LET分布的临床相关治疗计划应用不同的分级方法。使用具有人类唾液腺肿瘤细胞参数的可修复–有条件可修复（RCR）损伤模型，在考虑氧张力，剂量和LET的情况下计算了存活分数。临床缺氧增强率（OER）定义为低氧和氧合良好的肿瘤的肿瘤控制概率为50％所需的剂量比。对于所有的分馏，所得的OER均远高于1。对于低氧性肿瘤，如果假定存在LOC，则肿瘤控制的可能性要高得多，而不是静态氧合。 LOC的有益效果随馏分数量的增加而增加。然而，对于非常低的分数剂量，与LOC相关的改善并不能弥补肿瘤控制所需总剂量的增加。总之，我们的研究结果表明，由于SOBP低LET处的氧效应不可忽略，因此低氧可以影响碳离子放射治疗的结果。但是，如果发生LOC，则对于低氧亚体积的肿瘤，采用大范围的分级方案可以实现相对较高水平的肿瘤控制概率，但应谨慎进行超分割和超分割。

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