Dose Prediction Model for Duodenum Sparing With a Biodegradable Hydrogel Spacer for Pancreatic Cancer Radiation Therapy.
Dose Prediction Model for Duodenum Sparing With a Biodegradable Hydrogel Spacer for Pancreatic Cancer Radiation Therapy.
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用于胰腺癌放射治疗的可生物降解水凝胶垫片保留十二指肠的剂量预测模型
DOI：
10.1016/j.ijrobp.2018.07.184
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发表时间：
2018-11-01
期刊：
影响因子：
--
通讯作者：
Ding K
中科院分区：
文献类型：
--
作者：
Feng Z;Rao AD;Cheng Z;Shin EJ;Moore J;Su L;Kim SH;Wong J;Narang A;Herman JM;McNutt T;Li D;Ding K
我们之前已经展示了在胰腺癌放射治疗中使用可生物降解的水凝胶间隔物保留十二指肠的可行性。在本研究中，我们提出了重叠体积直方图（OVH）预测模型，作为选择可能受益于水凝胶放置的患者并预测实现临床限制所需的水凝胶间距的方法。十二指肠的 OVH 指标是从 232 名不可切除的胰腺癌患者的立体定向全身放射治疗 (SBRT) 计划中收集的（33Gy，分 5 次）。 OVH指标L9cc和L3cc被定义为十二指肠9cc和3cc体积与肿瘤重叠时的肿瘤体积扩张距离。十二指肠的D9cc和D3cc定义为十二指肠9cc和3cc的剂量体积直方图(DVH)剂量。通过Lx和Dx之间的线性回归建立预测模型，其中x=3cc和9cc。获得 OVH 阈值用于预测目标间隔物厚度。然后使用两具尸体标本和六名先前使用模拟垫片治疗的局部晚期胰腺癌患者的水凝胶注射前和注射后 CT 的治疗计划来评估预测模型的准确性。线性回归分析显示Lx和Dx之间存在显着相关性（L3cc-D3cc和L9cc-D9cc的r2分别=0.51和0.51，均P<0.01）。 OVH 阈值是 和 。从尸体标本和使用预测的目标垫片厚度的模拟垫片的临床患者的水凝胶注射前后 CT 观察到的十二指肠计划剂量 D3cc 和 D9cc 在 OVH 模型预测范围内。我们的模型可以预测哪些患者需要在 SBRT 之前放置水凝胶垫片以满足预先定义的剂量限制。此外，通过预测所需的目标水凝胶厚度，可以更好地指导间隔物注射以提高功效。我们建立了 OVH 预测模型来指导选择可能受益于放疗前注射水凝胶间隔物以保留十二指肠的胰腺癌患者。我们通过验证对实现临床剂量限制所需的水凝胶垫片厚度的预测来评估模型的准确性。我们即将进行的临床试验可以利用这项技术来确保十二指肠和胰腺之间充分分离，以考虑剂量递增的放射治疗。
We have previously shown the feasibility of duodenum sparing using a biodegradable hydrogel spacer in pancreatic cancer radiation therapy. In this study, we propose an overlap volume histogram (OVH) prediction model as a means to select patients who might benefit from hydrogel placement and to predict the required hydrogel spacing to achieve clinical constraints. OVH metrics for the duodenum were collected from the stereotactic body radiation therapy (SBRT) plans of 232 patients with unresectable pancreatic cancer (33Gy in 5 fractions). OVH metrics L9cc and L3cc were defined as the tumor volume expansion distance at which 9cc and 3cc volumes of the duodenum overlap with tumor. D9cc and D3cc of the duodenum were defined as the dose volume histogram (DVH) dose to 9cc and 3cc of the duodenum. Prediction models were established by linear regression between Lx and Dx, where x=3cc and 9cc. OVH thresholds were obtained for predicting the target spacer thickness. The accuracy of the prediction model was then evaluated using treatment plans on pre- and post- hydrogel injection CTs from two cadaver specimens and six previously treated locally advanced pancreatic cancer patients with simulated spacer. Linear regression analysis showed a significant correlation between Lx and Dx (r2 = 0.51 and 0.51 for L3cc-D3cc and L9cc-D9cc, respectively, both P<0.01). The OVH thresholds were and . The observed planning doses D3cc and D9cc of duodenum from pre- and post- hydrogel injection CTs of cadaver specimens and clinical patients with simulated spacer using predicted target spacer thickness were within the OVH model prediction range. Our model may predict which patients require placement of a hydrogel spacer before SBRT to meet pre-defined dose-constraints. Furthermore, by predicting the required target hydrogel thickness, the spacer injection can be better guided to improve efficacy. We established an OVH prediction model to guide the selection of pancreatic cancer patients who may benefit from hydrogel spacer injection before radiation for duodenum sparing. We evaluated the model’s accuracy by verifying predictions of the required hydrogel spacer thickness to achieve clinical dose constraints. Our upcoming clinical trials can utilize this technique to ensure sufficient separation between the duodenum and pancreas for consideration of dose-escalated radiation therapy.
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影响因子：
3.3
作者：
Jabbour, Salma K;Hashem, Sameh A;Bosch, Walter;Kim, Tae Kyoung;Finkelstein, Steven E;Anderson, Bethany M;Ben-Josef, Edgar;Crane, Christopher H;Goodman, Karyn A;Haddock, Michael G;Herman, Joseph M;Hong, Theodore S;Kachnic, Lisa A;Mamon, Harvey J;Pantarotto, Jason R;Dawson, Laura A
通讯作者：
Dawson, Laura A
影响因子：
254.7
作者：
Siegel, Rebecca;Ma, Jiemin;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
DOI：
10.1016/j.ijrobp.2003.11.004
发表时间：
2004-03-15
影响因子：
7
作者：
Koong, AC;Le, QT;Bastidas, JA
通讯作者：
Bastidas, JA
DOI：
10.1016/j.ijrobp.2015.12.003
发表时间：
2016-03-15
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Krishnan S;Chadha AS;Suh Y;Chen HC;Rao A;Das P;Minsky BD;Mahmood U;Delclos ME;Sawakuchi GO;Beddar S;Katz MH;Fleming JB;Javle MM;Varadhachary GR;Wolff RA;Crane CH
通讯作者：
Crane CH
影响因子：
3.7
作者：
Moningi S;Dholakia AS;Raman SP;Blackford A;Cameron JL;Le DT;De Jesus-Acosta AM;Hacker-Prietz A;Rosati LM;Assadi RK;Dipasquale S;Pawlik TM;Zheng L;Weiss MJ;Laheru DA;Wolfgang CL;Herman JM
通讯作者：
Herman JM