Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis.
Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis.
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DOI：
10.1186/1471-2407-13-397
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发表时间：
2013-08-27
期刊：
影响因子：
3.8
通讯作者：
Ma J
中科院分区：
文献类型：
--
作者：
Sun Y;Zhou GQ;Qi ZY;Zhang L;Huang SM;Liu LZ;Li L;Lin AH;Ma J
目的探讨鼻咽癌（NPC）患者调强放疗（IMRT）后颞叶损伤（TLI）的辐射体积效应和重要剂量学参数，以及颞叶的辐射耐受性。回顾性分析了20例经MRI诊断为单侧TLI的鼻咽癌患者。对剂量-体积数据进行回顾性分析。配对样本t检验显示，除TL体积（TLV）和V75（接受≥75戈伊的TLV，P分别为0.73和0.22）外，所有剂量测定参数均与TLI显著相关。受试者工作特征（ROC）曲线显示，V10和V20（P分别为0.552和0.11）是V10至V70 TLI的唯一非显著性预测因子。在多变量分析中，D0.5 cc（0.5 ml TLV的剂量）是TLI的独立预测因子（P < 0.001）; D0.5 cc的ROC曲线下面积为0.843（P < 0.001），69戈伊被视为放射剂量限值。高剂量“热点”区的分布与TLI的位置一致。69戈伊的D0.5cc可能是TL的剂量耐受性。TLI的风险高度依赖于TL中的高剂量“热点”;在IMRT治疗计划优化、审查和批准期间，医生应小心TL中的此类“热点”。
To identify the radiation volume effect and significant dosimetric parameters for temporal lobe injury (TLI) and determine the radiation dose tolerance of the temporal lobe (TL) in nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiation therapy (IMRT). Twenty NPC patients with magnetic resonance imaging (MRI)-diagnosed unilateral TLI were reviewed. Dose-volume data was retrospectively analyzed. Paired samples t-tests showed all dosimetric parameters significantly correlated with TLI, except the TL volume (TLV) and V75 (the TLV that received ≥75 Gy, P = 0.73 and 0.22, respectively). Receiver operating characteristic (ROC) curves showed V10 and V20 (P = 0.552 and 0.11, respectively) were the only non-significant predictors from V10 to V70 for TLI. D0.5cc (dose to 0.5 ml of the TLV) was an independent predictor for TLI (P < 0.001) in multivariate analysis; the area under the ROC curve for D0.5cc was 0.843 (P < 0.001), and the cutoff point 69 Gy was deemed as the radiation dose limit. The distribution of high dose ‘hot spot’ regions and the location of TLI were consistent. A D0.5cc of 69 Gy may be the dose tolerance of the TL. The risk of TLI was highly dependent on high dose ‘hot spots’ in the TL; physicians should be cautious of such ‘hot spots’ in the TL during IMRT treatment plan optimization, review and approval.
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影响因子：
19.7
作者：
Wang, Yi-Xiang J.;King, Ann D.;Ahuja, Anil T.
通讯作者：
Ahuja, Anil T.
DOI：
10.1016/j.ijrobp.2008.05.023
发表时间：
2009-03-15
影响因子：
7
作者：
Lee, Anne W. M.;Ng, W. T.;Bentzen, Soren M.
通讯作者：
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DOI：
10.1016/j.ijrobp.2010.03.001
发表时间：
2011-07-01
影响因子：
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作者：
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通讯作者：
Schulz-Ertner, Daniela
影响因子：
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作者：
Li, Wen-Fei;Sun, Ying;Ma, Jun
通讯作者：
Ma, Jun
DOI：
10.1016/s0360-3016(00)00585-x
发表时间：
2000-09-01
影响因子：
7
作者：
Xia, P;Fu, KK;Verhey, LJ
通讯作者：
Verhey, LJ