立体定向放射治疗（SBRT）已越来越多地用于肝脏肿瘤的消融。射波刀和质子束治疗 (PBT) 是两种先进的治疗技术，适合提供高剂量适形性和陡剂量梯度的 SBRT。然而，比较射波刀与 PBT 肝脏 SBRT 剂量特征的数据非常有限。 PBT 和 Cyber​​Knife 计划是使用 10 名既往接受过肝细胞癌 (HCC，N = 5) 和肝转移 (N = 5) 治疗的患者的 4DCT 数据集回顾性生成的。评估剂量体积直方图数据并与选定的标准进行比较；针对肝转移的剂量处方为 54 Gy（分 3 次），针对 HCC 的剂量处方为 45 Gy（分 3 次），以及先前发布的基于共识的正常组织剂量限制。评估参数的比较显示，靶区覆盖范围以及肝脏、肺和脊髓剂量存在统计学显着差异（p<0.05），而胸壁和皮肤并未表明两种方式之间存在显着差异。由于肿瘤靠近胸壁，同一患者的射波刀和质子计划都违反了许多最佳正常组织限制。 PBT 可以实现更大的器官保护，其程度主要取决于肿瘤位置。位于肝脏周边的肿瘤的器官保留增加最多。对于小目标体积，射波刀的器官保留与 PBT 相当。© 2024。作者。

Stereotactic body radiation therapy (SBRT) has been increasingly used for the ablation of liver tumours. CyberKnife and proton beam therapy (PBT) are two advanced treatment technologies suitable to deliver SBRT with high dose conformity and steep dose gradients. However, there is very limited data comparing the dosimetric characteristics of CyberKnife to PBT for liver SBRT. PBT and CyberKnife plans were retrospectively generated using 4DCT datasets of ten patients who were previously treated for hepatocellular carcinoma (HCC, N = 5) and liver metastasis (N = 5). Dose volume histogram data was assessed and compared against selected criteria; given a dose prescription of 54 Gy in 3 fractions for liver metastases and 45 Gy in 3 fractions for HCC, with previously published consensus-based normal tissue dose constraints. Comparison of evaluation parameters showed a statistically significant difference for target volume coverage and liver, lungs and spinal cord (p < 0.05) dose, while chest wall and skin did not indicate a significant difference between the two modalities. A number of optimal normal tissue constraints was violated by both the CyberKnife and proton plans for the same patients due to proximity of tumour to chest wall. PBT resulted in greater organ sparing, the extent of which was mainly dependent on tumour location. Tumours located on the liver periphery experienced the largest increase in organ sparing. Organ sparing for CyberKnife was comparable with PBT for small target volumes.© 2024. The Author(s).