Clinical observation on the therapeutic efficacy of cyberknife for primary or metastastic retroperitoneal tumors

( views:508, downloads:0 )
Author:
ZHUANG Hong-qing(Department of Radiation Oncology, Cancer Hospital of Tianjin Medical University, Tianjin Lung Cancer Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China)
YUAN Zhi-yong(Department of Radiation Oncology, Cancer Hospital of Tianjin Medical University, Tianjin Lung Cancer Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China)
WANG Ping(Department of Radiation Oncology, Cancer Hospital of Tianjin Medical University, Tianjin Lung Cancer Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China)
Journal Title:
Chinese Journal of Radiation Oncology
Issue:
Volume 21, Issue 05, 2012
DOI:
10.3760/cma.j.issn.1004-4221.2012.05.017
Key Word:
Retroperitoneal neoplasms/radiotherapy;Radiotherapy, Cyberknife;Prognosis

Abstract: Objective To evaluate the early response rate and radiation toxicity of cyberknife in the treatment of primary or metastastic retroperitoneal tumors.Methods Twenty-eight patients with retroperitoneal tumors were treated with cyberknife.The total doses were 2000-6000 cGy ( median 4500 cGy) and biological effective doses were 3750-10080 cGy (median 7680 cGy) in 2-10 fractions (median 5).Of all patients,3 received three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) boost,1 was treated as second-course radiotherapy,and others were treated with cyberknife only.The survival rates were calculated by Kaplan-Meier method and compared with Logrank test.Results The complete response,partial response,stable disease and progression disease rates were 43%(12/28),6% ( 10/28),18% ( 5/28 ),4% ( 1/28 ),respectively.The overall response rate was 96%.The number of patients who were followed up more than 1,2,3 years were 17,9,7,respectively.The 1-,2-and 3-year local control rates were 92%,86% and 86%,respectively.The 1-,2-and 3-year overall survival rates were 60%,49% and 49%,respectively.The difference between local progression-free survival and overall survival was not significant ( median 9.5 and 12.0 months,x2 =0.17,P =0.680).Moreover,if the patients did not have metastasis elsewhere and local treatment was effective,there was no significant difference between local progression-free survival and progression free survival (median 17 and 11 months,x2 =0.13,P=0.720).Acute radiation-induced side effects (≥ 2 grade) such as fatigue,anorexia,nausea,vomiting and epigastric discomfort occurred in 9,9,7,7 and 2 patients,respectively.Intestinal stenosis of 1 grade occurred in 1 patient.Conclusions Radiotherapy for retroperitoneal tumors with cyberknife has provided a high response rate with minimal side effects.It is a safe and effective local treatment method for retroperitoneal tumors.

  • [1]Paumier A,Bonvalot S,Beaudre A,et al.Intensity modulated radiotherapy as adjuvant post-operative treatment for retroperitoncal sarcoma:acute toxicity.Cancer Radiother,2011,15:413-420.
  • [2]Paumier A,Pechoux C,Beaudre,A,et al.IMRT or conformal radiotherapy for adjuvant treatment of retroperitoneal sarcoma?Radiother Oncol,2011,99:71-78.
  • [3]Bolla M,Sarrazin R,Salvat J,et al.Feasibility of retroperitoneal pelvic lymph node exploration in cancers of the cervix treated by radiosurgery association or radiotherapy alone.Apropos of a series of 52 cases.Bull Cancer Radiother,1995,82:326-33l.
  • [4]Warszawski N,Schmucking M,Samtleben M,et al.Radiotherapy of regional lymph nodes compared to retroperitoneal lymphadenectomy in the treatment of seminomas.Retrospective analysis of 161 patients.Strahlenther Onkol,1996,172:250-254.
  • [5]Thariat J, Marcie S, Marcy PY, et al.Cyherknife robotic stereotactic radiotherapy: technical aspects and recent developments.Bull Cancer,2010,97:807-818.
  • [6]Kurup G.CyberKnife:a new paradigm in radiotherapy.J Med Phys,2010,35:63-64.
  • [7]Scalchi P,Righetto R,Cavedon C,et al.Direct tumor in vivo dosimetry in highly-conformal radiotherapy:a feasibility study of implantable MOSFETs for hypofractionated extracranial treatments using the Cyberknife system.Med Phys,2010,37:1413-1423.
  • [8]Bondiau PY,Benezerv K,Beckendorf V,et al.CyherKnife robotic stereotactic radiotherapy:technical aspects and medical indications.Cancer Radiother,2007,11:338-344.
  • [9]Eisenhauer EA,Therasse P,Bogaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline (version 1.1).Eur J Cancer,2009,45:228-247.
  • [10]Watanabe H,Okada M,Kaji Y,et al.New response evaluation criteria in solid tumours-revised RECIST guideline (version 1.1).Gan To Kagaku Ryoho,2009,36:2495-2501.
  • [11]Trotti A,Colevas AD,Setser A,et al.CTCAE v3.0:development of a comprehensive grading system for the adverse effects of cancer treatment.Semin Radiat Oncol,2003,13:176-181.
  • [12]Palazzi M,Tomatis S,Odandi E,et al.Effects of treatment intensification on acute local toxicity during radiotherapy for head and neck cancer:prospective observational study validating CTCAE,version 3.0,seoring system.Int J Radiat Oncol Biol Phys,2008,70:330-337.
  • [13]Yavuzcan A,Baloglu A,Cetinkaya B.The investigation of the factors affecting retroperitoneal lymph node metastasis in stage ⅢC and Ⅳ epithelial ovarian cancer.Arch Gynecol Obstet,2009,280:939-944.
  • [14]Hashimoto S,Isaka S,Okano T,et al.Three dimensional image analysis on retroperitoneal lymph node metastasis of testicular cancer.Nippon Hinyokika Gakkai Zasshi,1994,85:1388-1394.
  • [15]Shinoto M,Ishigami K,Yoshimitsu K,et al.Posterior iliac crest lymph node metastasis from ovarian cancer 15 years after surgery:a mimieker of primary retroperitoneal tumor.Eur Radiol,2006,16:2126-2127.
  • [16]Tsumura N,Sakuragi N,Hareyama H,et al.An analysis of pelvic and para-aortic lymph node metastasis in ovarian carcinoma by systematie retroperitoneal lymph node dissection.Nippon Sanka Fujinka Gakkai Zasshi,1996,48:508-514.
  • [17]Khalifa MA,Maksymov V,Rowsell C.Retroperitoneal margin of the pancreaticoduodenectomy specimen:anatomic mapping for the surgical pathologist.Virchows Arch,2009,454:125-131.
  • [18]Nishino M, Hayakawa K, Minami M, et al. Primary retroperitoneal neoplasms:CT and MR imaging findings with anatomic and pathologic diagnostic clues.Radiographics,2003,23:45-57.
  • [19]Goodman KA,Wiegner EA,Maturen KE,et al.Dose-escalation study of single-fraction stereotactic body radiotherapy for liver malignancies.Int J Radiat Oncol Biol Phys,2010,78:486-493.
  • [20]Brown WT,Fayad F,Hevezi J,et al.Individualized higher dose of 70-75 Gy using five-fraction rohotic stereotactic radiotherapy for non-small cell lung cancer:a feasibility study.Comput Aided Surg,2011,16:1-10.
  • [21]Murphy MJ,Lin PS,Ozhasoglu C.Intra-fraction dose delivery timing during stereotactic radiotherapy can influence the radiobiological effect.Med Phys,2007,34:481-484.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn