Selection criteria for 3D conformal radiotherapy versus volumetric-modulated arc therapy in highgrade glioma based on normal tissue complication probability of brain
Selection criteria for 3D conformal radiotherapy versus volumetric-modulated arc therapy in highgrade glioma based on normal tissue complication probability of brain
复制标题
基于脑部正常组织并发症概率的高级别胶质瘤3D适形放射治疗与体积调制弧形治疗的选择标准
DOI：
10.1093/jrr/rry106
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发表时间：
2019
影响因子：
2
通讯作者：
Hidefumi Aoyama
中科院分区：
文献类型：
--
作者：
Satoshi Tanabe;Haruna Takahashi;Hirotake Saito;Atsushi Ohta;Toshimichi Nakano;Ryuta Sasamoto;Miki Shioi;Satoru Utsunomiya;Eisuke Abe;Motoki Kaidu;Hidefumi Aoyama
目前还没有定量选择标准来确定高级别胶质瘤（HGG）患者是否适合进行体积调节电弧治疗（VMAT）。本研究旨在制定可用于选择HGG最佳治疗方式的选择标准。我们分析了20例采用三维适形放疗（3DCRT）治疗的HGG患者。首先，回顾性地为每位患者制定VMAT计划。对每个方案计算正常脑正常组织并发症概率（NTCP）。然后我们根据正常大脑3DCRT计划的entcp进行分组，使用5%的阈值。我们比较了两种方案的entcp和两组的总肿瘤体积（gtv）。对于gtv，我们使用接收者工作特征曲线来确定预测ntcp < 5%的临界值。我们分别确定了GTV与GTV的最大横截直径和最大横截面积之间的相关性。在entcp≥5%组，VMAT方案的entcp显著低于3DCRT方案（P= 0.0011）。entcp≥5%组的gtv显著大于entcp < 5%组（P= 0.0016）， gtv的临界值为130.5 cm3。gtv与gtv的最大横截直径（R2= 0.82）和最大横截面积（R2= 0.94）密切相关，其临界值分别为7.5 cm和41 cm2。在gtvis≥130.5 cm3的病例中，VMAT比3DCRT更合适。
There are no quantitative selection criteria for identifying high-grade glioma (HGG) patients who are suited for volumetric-modulated arc therapy (VMAT). This study aimed to develop selection criteria that can be used for the selection of the optimal treatment modality in HGG. We analyzed 20 patients with HGG treated by 3D conformal radiotherapy (3DCRT). First, VMAT plans were created for each patient retrospectively. For each plan, the normal tissue complication probability (NTCP) for normal brain was calculated. We then divided the patients based on theNTCPs of the 3DCRT plans for normal brain, using the threshold of 5%. We compared theNTCPs of the two plans and the gross tumor volumes (GTVs) of the two groups. For theGTVs, we used receiver operating characteristic curves to identify the cut-off value for predictingNTCP< 5%. We determined the respective correlations between theGTVand the GTV’s largest cross-sectional diameter and largest cross-sectional area. In theNTCP≥ 5% group, theNTCPs for the VMAT plans were significantly lower than those for the 3DCRT plans (P= 0.0011). TheNTCP≥ 5% group’sGTVwas significantly larger than that of theNTCP< 5% group (P= 0.0016), and the cut-off value of theGTVwas 130.5 cm3. TheGTVwas strongly correlated with theGTV’s largest cross-sectional diameter (R2= 0.82) and largest cross-sectional area (R2= 0.94), which produced the cut-off values of 7.5 cm and 41 cm2, respectively. It was concluded that VMAT is more appropriate than 3DCRT in cases in which theGTVis ≥130.5 cm3.