総 説 小 動 物 臨 床 関 連 部 門 Radiation therapy for cancer: current status and future directions in veterinary medicine Takashi MORI Faculty of Applied Biological Sciences, Gifu University, 1 1 Yanagido, Gifu, 501 1193, Japan 1 は じ め に 2 3 次 元 原 体 照 射 (three-dimensional conformal radiation therapy : 3D-CRT) X D CRT CT CT D CRT X multi-leaf collimator : MLC CT radiation treatment planning system : RTPS CT organ at risk : OAR X CT OAR forward planning FAX E-mail : tmori@gifu-u.ac.jp Correspondence to : Takashi MORI (Faculty of Applied Biological Sciences, Gifu University) 1 1 Yanagido, Gifu, 501 1193, Japan TEL 058 293 2962 FAX 058 293 2928 E-mail : tmori@gifu-u.ac.jp 173
A B A B RTPS MLC 3 強 度 変 調 放 射 線 治 療 (intensity-modulated radiation therapy : IMRT) IMRT D CRT X D CRT IMRT OAR D CRT OAR IMRT MLC X MLC MLC IMRT D CRT OAR RTPS X inverse planning IMRT 174
IMRT stereotactic radiotherapy : SRT STI 4 画 像 誘 導 放 射 線 治 療 (image-guided radiation therapy : IGRT) IMRT volume effect OAR SRT SRT IGRT X CT RTPS 6 化 学 放 射 線 療 法 (chemoradiotherapy) IGRT inter-fractional motion intra-fractional motion inter-fractional motion intrafractional motion intra-fractional motion 5 定 位 放 射 線 治 療 (stereotactic irradiation : STI) STI mm EGFR stereotactic radiosurgery : SRS EGFR 175
8 大 線 量 小 分 割 照 射 の 問 題 X, VEGFR VEGFR 7 空 間 的 分 割 グリッド 照 射 (spatially fractionated GRID radiation therapy : SFGRT) SFGRT, SFGRT TNF TGF SFGRT dose escalation LQ LQ in vitro Gy, in vivo LQ 9 人 材 及 びコスト 面 の 問 題 IMRT IGRT 引 用 文 献 Takahashi S : Conformation radiotherapy. Rotation techniques as applied to radiography and radiotherapy of cancer, Acta Radiol Diagn (Stockh), Suppl 176
: + Farrelly J, McEntee MC : A Survey of Veterinary Radiation Facilities in, Vet Radiol Ultrasound, in press. Covey JL, Farese JP, Bacon NJ, Schallberger SP, Amsellem P, Cavanaugh RP, Milner RJ : Stereotactic radiosurgery and fracture fixation in dogs with appendicular osteosarcoma, Vet Surg,, Mariani CL, Schubert TA, House RA, Wong MA, Hopkins AL, Barnes Heller HL, Milner RJ, Lester NV, Lurie DM, Rajon DA, Friedman WA, Bova FJ : Frameless stereotactic radiosurgery for the treatment of primary intracranial tumours in dogs, Vet Comp Oncol Nolan MW, Griffin LR, Custis JT, LaRue SM : Stereotactic body radiation therapy for treatment of injection-site sarcomas in cats: cases ( ), J Am Vet Med Assoc,, Fidel J, Lyons J, Tripp C, Houston R, Wheeler B, Ruiz A : Treatment of oral squamous cell carcinoma with accelerated radiation therapy and concomitant carboplatin in cats, J Vet Intern Med,, Marconato L, Nitzl DB, Melzer-Ruess KJ, Keller MA, Buchholz J : Chemotherapy and radiation therapy in dogs with muscle-invasive transitional cell carcinoma of the urinary tract, Can Vet J,, Williams LE, Pruitt AF, Thrall DE : Chemotherapy followed by abdominal cavity irradiation for feline lymphoblastic lymphoma, Vet Radiol Ultrasound,, Bonner JA, Harari PM, Giralt J, Cohen RB, Jones CU, Sur RK, Raben D, Baselga J, Spencer SA, Zhu J, Youssoufian H, Rowinsky EK, Ang KK : Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: -year survival data from a phase randomised trial, and relation between cetuximabinduced rash and survival, Lancet Oncol,, Ang KK, Zhang Q, Rosenthal DI, Nguyen-Tan PF, Sherman EJ, Weber RS, Galvin JM, Bonner JA, Harris J, El-Naggar AK, Gillison ML, Jordan RC, Konski AA, Thorstad WL, Trotti A, Beitler JJ, Garden AS, Spanos WJ, Yom SS, Axelrod RS : Randomized Phase III Trial of Concurrent Accelerated Radiation Plus Cisplatin With or Without Cetuximab for Stage III to IV Head and Neck Carcinoma: RTOG, J Clin Oncol Jakob J, Rauch G, Wenz F, Hohenberger P : Phase I trial of concurrent sunitinib and radiation therapy as preoperative treatment for soft tissue sarcoma, BMJ Open,, e Barney BM, Markovic SN, Laack NN, Miller RC, Sarkaria JN, Macdonald OK, Bauer HJ, Olivier KR : Increased bowel toxicity in patients treated with a vascular endothelial growth factor inhibitor (VEGFI) after stereotactic body radiation therapy (SBRT), Int J Radiat Oncol Biol Phys,, Mangoni M, Vozenin MC, Biti G, Deutsch E : Normal tissues toxicities triggered by combined anti-angiogenic and radiation therapies: hurdles might be ahead, Br J Cancer,, Buckey C, Stathakis S, Cashon K, Gutierrez A, Esquivel C, Shi C, Papanikolaou N : Evaluation of a commercially-available block for spatially fractionated radiation therapy, J Appl Clin Med Phys,, Neuner G, Mohiuddin MM, Vander Walde N, Goloubeva O, Ha J, Yu CX, Regine WF : High-dose spatially fractionated GRID radiation therapy (SFGRT): a comparison of treatment outcomes with Cerrobend vs. MLC SFGRT, Int J Radiat Oncol Biol Phys,, Penagaricano JA, Griffin R, Corry P, Moros E, Yan Y, Ratanatharathorn V : Spatially fractionated (GRID) therapy for large and bulky tumors, J Ark Med Soc,, Park C, Papiez L, Zhang S, Story M, Timmerman RD : Universal survival curve and single fraction equivalent dose: useful tools in understanding potency of ablative radiotherapy, Int J Radiat Oncol Biol Phys,, Guerrero M, Li XA : Extending the linear-quadratic model for large fraction doses pertinent to stereotactic radiotherapy, Phys Med Biol,, 177