DOSE-VOLUME HISTOGRAM PARAMETERS AND LOCAL TUMOR CONTROL IN MAGNETIC RESONANCE IMAGE-GUIDED CERVICAL CANCER BRACHYTHERAPY
DOSE-VOLUME HISTOGRAM PARAMETERS AND LOCAL TUMOR CONTROL IN MAGNETIC RESONANCE IMAGE-GUIDED CERVICAL CANCER BRACHYTHERAPY
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DOI：
10.1016/j.ijrobp.2008.10.033
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发表时间：
2009-09-01
影响因子：
7
通讯作者：
Poetter, Richard
中科院分区：
文献类型：
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作者：
Dimopoulos, Johannes C. A.;Lang, Stefan;Poetter, Richard
目的：探讨剂量-体积直方图（DVH）参数预测局部控制的磁共振（MR）图像引导近距离放射治疗（IGBT）的宫颈cancer.Methods和材料：我们的研究人群包括141例宫颈癌（阶段IB-IVA）与45-50戈伊外照射放疗加4倍7戈伊IGBT或不顺铂治疗。勾画大体肿瘤体积（GTV）、高风险临床靶体积（HRCTV）和中风险临床靶体积（IRCTV），并评估DVH参数（输送至90%感兴趣体积的最小剂量[D90]和D100）。通过应用线性二次模型（α/β = 10戈伊），将剂量转换为2戈伊（EQD 2）的等效剂量。根据诊断时肿瘤大小（诊断时GTV [GTVD]为2-5 cm（组1）或大于5 cm（组2））和IGBT时肿瘤大小反应（HRCTV）为2-5 cm（组2a）或大于5 cm（组2b），对真骨盆中有或无局部复发（LR）的患者进行分组。与LR相关的最重要的DVH参数是HRCTV的D90和D100。HRCTV的平均D90和D100值分别为86 16和65 10戈伊。HRCTV的D90大于87戈伊导致LR发生率为4%（3/68），而D90小于87戈伊导致LR发生率为20%（15/73）。效果是最明显的肿瘤组（组2b）。结论：我们显示了增加局部控制IGBT的宫颈癌患者的剂量，这可以表示为HRCTV的D90和D100。如果HRCTV的D90（EQD 2）为87戈伊或更高，则可实现大于95%的局部控制率。(C)2009 Elsevier Inc.
Purpose: To investigate the value of dose-volume histogram (DVH) parameters for predicting local control in magnetic resonance (MR) image-guided brachytherapy (IGBT) for patients with cervical cancer.Methods and Materials: Our study population consists of 141 patients with cervical cancer (Stages IB-IVA) treated with 45-50 Gy external beam radiotherapy plus four times 7 Gy IGBT with or without cisplatin. Gross tumor volume (GTV), high-risk clinical target volume (HRCTV), and intermediate-risk clinical target volume (IRCTV) were contoured, and DVH parameters (minimum dose delivered to 90% of the volume of interest [D90] and D100) were assessed. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (alpha/beta = 10 Gy). Groups were defined for patients with or without local recurrence (LR) in the true pelvis for tumor size at diagnosis (GTV at diagnosis [GTVD] of 2-5 cm (Group 1) or greater than 5 cm (Group 2) and for tumor size response at IGBT (HRCTV) of 2-5 cm (Group 2a) or greater than 5 cm (Group 2b).Results: Eighteen LRs were observed. The most important DVH parameters correlated with LR were the D90 and D100 for HRCTV. Mean D90 and D100 values for HRCTV were 86 16 and 65 10 Gy, respectively. The D90 for HRCTV greater than 87 Gy resulted in an LR incidence of 4% (3 of 68) compared with 20% (15 of 73) for D90 less than 87 Gy. The effect was most pronounced in the tumor group (Group 2b).Conclusions: We showed an increase in local control in IGBT in patients with cervical cancer with the dose delivered, which can be expressed by the D90 and D100 for HRCTV. Local control rates greater than 95% can be achieved if the D90 (EQD2) for HRCTV is 87 Gy or greater. (C) 2009 Elsevier Inc.