LATENT-TIME ESTIMATION FOR LATE CUTANEOUS AND SUBCUTANEOUS RADIATION REACTIONS IN A SINGLE-FOLLOW-UP CLINICAL-STUDY
LATENT-TIME ESTIMATION FOR LATE CUTANEOUS AND SUBCUTANEOUS RADIATION REACTIONS IN A SINGLE-FOLLOW-UP CLINICAL-STUDY
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DOI：
10.1016/0167-8140(89)90095-9
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发表时间：
1989-07-01
影响因子：
5.7
通讯作者：
OVERGAARD, M
中科院分区：
文献类型：
--
作者：
BENTZEN, SM;THAMES, HD;OVERGAARD, M
在本文中，分析的分馏敏感性和潜伏期的皮下纤维化和毛细血管扩张症的临床系列。该系列包括163例乳腺癌患者，从1978年至1980年，接受乳房切除术后照射提供了12个部分，每周2个部分，为期37至46天。最大吸收剂量为51.36戈伊，最小目标剂量为36.6戈伊。从1981年至1982年，66例患者接受了最小目标剂量40.92戈伊，分22次给药，每周5次，持续29至35天。在至少16个月的观察时间后，在单次随访时前瞻性评估晚期并发症。分析的临床终点为皮下纤维化和毛细血管扩张。使用混合模型分析数据，该模型结合了剂量分割和潜伏期效应。中度或重度并发症最终频率的90%表达的时间长度为3.2年（95%置信限（c.l.）[2.3，3.9]年）和4.7年（95% c.l. [4.0，4.8]岁），而α/.β的比值为1.9戈伊（95% c.l.）[0.8，3.0]戈伊和3.7戈伊（95% c.l. [0.2戈伊）。对于皮下纤维化，达到特定反应级别的时间随着级别的增加而增加，因此与纤维化严重程度随时间推移而进展的临床印象一致。如果不考虑潜伏期和删失效应，可能会导致严重低估随访不完整组的放射并发症的最终频率。
In this paper, an analysis of the fractionation sensitivity and latency of subcutaneous fibrosis and telangiectasia in a clinical series is presented. The series comprised 163 breast cancer patients who, from 1978 to 1980, received postmastectomy irradiation delivered in 12 fractions with 2 fraction per week over a period 37 to 46 days. The total dose was specified either as a maximum absorbed dose of 51.36 Gy, or as a minimum targe dose of 36.6 Gy specified at the level of athe mid-axilla. From 1981 to 1982, 66 patients received a minimum target dose of 40.92 Gy in 22 fractions administered as 5 fractions per week over 29 to 35 days. Late complications were evaluated prospectively at a single follow-up after a minimum observation time of 16 months. The clinical endpoints analyzed were subcutaneous fibrosis and telangiectasia. The data were analyzed using a mixture model that incorporates both dose fractionation and latency effects. The length of time to expression of 90% of the ultimate frequency of moderate or severe complications was 3.2 years (95% confidence limits (c.l.) [2.3,3.9] years) and 4.7 years (95% c.l. [4.0,4.8] years) for fibrosis and telangiectasia respectively, while the .alpha./.beta. ratios were 1.9 Gy (95% c.l. [0.8,3.0] Gy and 3.7 Gy (95% c.l. [0.2,47] Gy), respectively. For subcutaneous fibrosis the time to reach a specific grade of reaction increases with the grade, thus being consistent with the clinical impression that fibrosis progresses in severity over time. If latency and censoring effects are unaccounted for, serious underestimates of the ultimate frequency of radiation complications in groups with incomplete follow-up may result.