A two-variable linear model of parotid shrinkage during IMRT for head and neck cancer
A two-variable linear model of parotid shrinkage during IMRT for head and neck cancer
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DOI：
10.1016/j.radonc.2009.12.014
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发表时间：
2010-02-01
影响因子：
5.7
通讯作者：
Calandrino, Riccardo
中科院分区：
文献类型：
--
作者：
Broggi, Sara;Fiorino, Claudio;Calandrino, Riccardo
目的：为了评估解剖，临床和剂量学治疗前的参数，可能预测腮腺收缩放疗期间的头颈癌（HNC）。材料：数据174腮腺从四个机构进行了分析，患者接受调强放射治疗，根治性和辅助的意图。通过CT图像（MVCT为40例患者，KVCT为47例患者）评估的治疗结束时和治疗开始时腮腺体积之间的体积差异（Δ V）评价腮腺收缩。评估了Delta γ/%与剂量测定、临床和几何参数之间的相关性。通过将大于中位值的Delta/%视为终点，进行单变量和逐步logistic多变量（MVA）分析。线性模型的三角洲V（连续变量）的基础上发现在MVA.Results的最具预测性的变量：中位三角洲/%分别为6.95毫升和26%。最具预测性的MVA时Delta V2的独立变量是初始腮腺体积（IPV，OR：1.100; p = 0.0002）和Dmean（OR：1.059; p = 0.038）。MVA时Delta V%的主要独立预测因素为年龄（OR：0.968; p = 0.041）和V40（OR：1.0338; p = 0.013）。Δ V % = 34.23 + 0.192 V40（戈伊）- 0.2203年龄（岁）。结论：IPV/年龄和Dmean/V40是Delta V40和Delta V40的主要剂量学和临床/解剖学预测因子。Delta V和Delta V%可以通过包括上述变量的双线性模型很好地描述。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学94（2010）206-212
Purpose: To assess anatomical, clinical and dosimetric pre-treatment parameters, possibly predictors of parotid shrinkage during radiotherapy of head and neck cancer (HNC).Materials: Data of 174 parotids from four institutions were analysed; patients were treated with IMRT, with radical and adjuvant intent. Parotid shrinkage was evaluated by the volumetric difference (Delta V) between parotid volumes at the end and those at the start of the therapy, as assessed by CT images (MVCT for 40 patients, KVCT for 47 patients). Correlation between Delta Vcc/% and a number of dosimetric, clinical and geometrical parameters was assessed. Univariate as well as stepwise logistic multivariate (MVA) analyses were performed by considering as an end-point a Delta Vcc/% larger than the median value. Linear models of Delta V (continuous variable) based on the most predictive variables found at the MVA were developed.Results: Median Delta Vcc/% were 6.95 cc and 26%, respectively. The most predictive independent variables of Delta Vcc at MVA were the initial parotid volume (IPV, OR: 1.100; p = 0.0002) and Dmean (OR: 1.059; p = 0.038). The main independent predictors of Delta V% at MVA were age (OR: 0.968; p = 0.041) and V40 (OR: 1.0338; p = 0.013). Delta Vcc and Delta V% may be well described by the equations: Delta Vcc = 2.44 + 0.076 Dmean (Gy) + 0.279 IPV (cc) and Delta V% = 34.23 + 0.192 V40 (%) - 0.2203 age (year). The predictive power of the Delta Vcc model is higher than that of the Delta V% model.Conclusions: IPV/age and Dmean/V40 are the major dosimetric and clinical/anatomic predictors of Delta Vcc and Delta V%. Delta Vcc and Delta V% may be well described by hi-linear models including the above-mentioned variables. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 94 (2010) 206-212