Evaluation of two dose-volume histogram reduction models for the prediction of radiation pneumonitis
Evaluation of two dose-volume histogram reduction models for the prediction of radiation pneumonitis
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DOI：
10.1016/s0167-8140(98)00020-6
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发表时间：
1998-07-01
影响因子：
5.7
通讯作者：
Lebesque, JV
中科院分区：
文献类型：
--
作者：
Kwa, SLS;Theuws, CM;Lebesque, JV
目的：为了评估平均肺剂量和两种剂量体积直方图（DVH）减少技术的三维剂量distributions.Patients和方法之间的相似性：肺DVH计算从恶性淋巴瘤（44），乳腺癌（42）和肺癌（20）治疗的患者的三维剂量分布。使用DVH减少技术，通过等效均匀剂量（EUD）总结DVH，该量与正常组织并发症概率（NTCP）直接相关。使用了两种DVH减少技术。第一种是基于Kutcher等人提出的经验模型（Kutcher，G. J.，伯尔曼角，澳-地布鲁斯特，理学硕士，Goitein，M.和Mohan，R.用于计算三维治疗计划评价的并发症概率的直方图简化方法。国际辐射杂志Oncol. 21：137-146，1991），其需要体积指数n。测试了几个n值。第二种技术基于放射生物学模型，即由Niemierko等人开发的平行功能亚基模型（Niemierko，A.和Goitein，M.正常组织对辐射反应的模拟：临界体积模型。国际辐射杂志Oncol. 25：135-145，1993）和杰克逊等人（杰克逊，A.，Kutcher，G.J.和Yorke，E.D.平行结构的正常组织在非均匀辐照下辐射诱发并发症的概率。20：613-625，1993）：需要说明局部剂量-效应关系。从灌注和通气SPECT data.Results的分析中获得这种关系：它可以分析表明，这两个DVH减少技术是相同的，如果局部剂量效应关系服从幂律关系在临床剂量范围内。基于灌注和通气SPECT数据的局部剂量-效应关系确实可以在0-80戈伊范围内拟合幂律关系，从中推导出n = 0.8-0.9的值。这些对应于肺组织的常用值n = 0.87，并产生EUDn=0.87的值，这与平均肺剂量几乎相同。对于没有实验数据的其他n值，EUD和平均剂量值之间存在差异。恶性淋巴瘤6例（6/44），乳腺癌0例（0/42）。这些情况下，只发生在高值的平均肺dose.Conclusion：两个DVH减少技术是相同的肺，是非常相似的平均剂量计算。对于其他模型参数值，这两种技术也相对相似。(C)1998爱思唯尔科学爱尔兰有限公司保留所有权利。
Purpose: To evaluate the similarities between the mean lung dose and two dose-volume histogram (DVH) reduction techniques of 3D dose distributions of the lung.Patients and methods: DVHs of the lungs were calculated from 3D dose distributions of patients treated for malignant lymphoma (44), breast cancer (42) and lung cancer (20). With a DVH reduction technique, a DVH is summarized by the equivalent uniform dose (EUD), a quantity which is directly related to the normal tissue complication probability (NTCP), Two DVH reduction techniques were used. The first was based on an empirical model proposed by Kutcher et al. (Kutcher, G.J., Burman, C., Brewster, M.S., Goitein, M. and Mohan, R. Histogram reduction method for calculating complication probabilities for three-dimensional treatment planning evaluations. Int. J. Radiat. Oncol. Biol. Phys. 21: 137-146, 1991), which needs a volume exponent n. Several values for n were tested. The second technique was based on a radiobiological model, the parallel functional subunit model developed by Niemierko et al. (Niemierko, A. and Goitein, M. Modeling of normal tissue response to radiation: the critical volume model. Int. J. Radiat. Oncol. Biol. Phys. 25: 135-145, 1993) and Jackson et al. (Jackson, A., Kutcher, G.J. and Yorke, E.D. Probability of radiation-induced complications for normal tissues with parallel architecture subject to non-uniform irradiation. Med. Phys. 20: 613-625, 1993): for which a local dose-effect relation needed to be specified. This relation was obtained from an analysis of perfusion and ventilation SPECT data.Results: It can be shown analytically that the two DVH reduction techniques are identical, if the local dose-effect relation obeys a power-law relationship in the clinical dose range. Local dose-effect relations based on perfusion and ventilation SPECT data can indeed be fitted with a power-law relationship in the range 0-80 Gy, from which values of n = 0.8-0.9 were deduced. These correspond to the commonly used value of n = 0.87 for lung tissue and yielded EUDn=0.87 values which were almost identical to the mean lung doses. For other n values, for which no experimental data are present, differences exist between EUD and mean dose values. Six patients with malignant lymphoma (6/44) and none of the breast cancer patients (0/42) developed radiation pneumonitis. These cases occurred only at high values for the mean lung dose.Conclusion: The two DVH reduction techniques are identical for lung and are very similar to mean dose calculations. The two techniques are also relatively similar for other model parameter values. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.