DOSE-VOLUME HISTOGRAM PARAMETERS AND LATE SIDE EFFECTS IN MAGNETIC RESONANCE IMAGE-GUIDED ADAPTIVE CERVICAL CANCER BRACHYTHERAPY
DOSE-VOLUME HISTOGRAM PARAMETERS AND LATE SIDE EFFECTS IN MAGNETIC RESONANCE IMAGE-GUIDED ADAPTIVE CERVICAL CANCER BRACHYTHERAPY
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DOI：
10.1016/j.ijrobp.2009.11.002
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发表时间：
2011-02-01
影响因子：
7
通讯作者：
Poetter, Richard
中科院分区：
文献类型：
--
作者：
Georg, Petra;Lang, Stefan;Poetter, Richard
目的：评估剂量体积直方图（DVH）参数的预测价值的直肠，乙状结肠，膀胱在图像引导下近距离放射治疗宫颈癌patients.Methods和材料：共141例患者接受外照射放疗和图像引导下近距离放射治疗有或无化疗。计算直肠、乙状结肠和膀胱最大暴露量2、1和0.1 cm（3）（D（2cc）、D（1cc）和D（0.1cc））的DVH参数，以及国际辐射单位和测量委员会点剂量（D（ICRU））。通过应用线性二次模型（α/β = 3戈伊），将总剂量转换为2戈伊的等效剂量。使用正常组织中的晚期效应主观、客观、管理和分析评分前瞻性评估晚期副作用。定义了以下患者组：第1组：无副作用（0级）;第2组：副作用（1-4级）;第3组：轻微副作用（0-1级）;第4组：主要副作用（2-4级）。总的5年精算副作用率为直肠12%，乙状结肠3%，膀胱23%。直肠平均总D（2cc）为65 +/- 12戈伊，乙状结肠为62 +/- 12戈伊，膀胱为95 +/- 22戈伊。对于直肠，在所有DVH参数和D（ICRU）中观察到组1和组2之间的统计学显著差异。在第3组和第4组之间，未观察到D（0.1 cc）的差异。对于乙状结肠，在所有组中观察到D（2cc）和D（1cc）的显著差异，但D（0.1cc）的差异不显著。对于膀胱，仅在第3组和第4组之间观察到所有DVH参数的显著差异。结论：D（2cc）和D（1cc）参数对直肠毒性有较好的预测价值。对于S形，由于数据有限，无法假设预测。在膀胱中，DVH参数仅预测主要毒性。(C)2011 Elsevier Inc.
Purpose: To evaluate the predictive value of dose volume histogram (DVH) parameters for late side effects of the rectum, sigmoid colon, and bladder in image-guided brachytherapy for cervix cancer patients.Methods and Materials: A total of 141 patients received external-beam radiotherapy and image-guided brachytherapy with or without chemotherapy. The DVH parameters for the most exposed 2, 1, and 0.1 cm(3) (D(2cc), D(1cc) and D(0.1cc)) of the rectum, sigmoid, and bladder, as well as International Commission on Radiation Units and Measurements point doses (D(ICRU)) were computed. Total doses were converted to equivalent doses in 2 Gy by applying the linear-quadratic model (alpha/beta = 3 Gy). Late side effects were prospectively assessed using the Late Effects in Normal Tissues Subjective, Objective, Management and Analytic score. The following patient groups were defined: Group 1: no side effects (Grade 0); Group 2: side effects (Grade 1-4); Group 3: minor side effects (Grade 0-1); and Group 4: major side effects (Grade 2-4).Results: The median follow-up was 51 months. The overall 5-year actuarial side effect rates were 12% for rectum, 3% for sigmoid, and 23% for bladder. The mean total D(2cc) were 65 +/- 12 Gy for rectum, 62 +/- 12 Gy for sigmoid, and 95 +/- 22 Gy for bladder. For rectum, statistically significant differences were observed between Groups 1 and 2 in all DVH parameters and D(ICRU). Between Groups 3 and 4, no difference was observed for D(0.1cc). For sigmoid, significant differences were observed for D(2cc) and D(1cc), but not for D(0.1cc) in all groups. For bladder, significant differences were observed for all DVH parameters only comparing Groups 3 and 4. No differences were observed for DICRU.Conclusions: The parameters D(2cc) and D(1cc) have a good predictive value for rectal toxicity. For sigmoid, no prediction could be postulated because of limited data. In bladder, DVH parameters were predictive only for major toxicity. (C) 2011 Elsevier Inc.