LOCAL-CONTROL, TCD50 AND DOSE-TIME PRESCRIPTION HABITS IN RADIOTHERAPY OF HEAD AND NECK TUMORS
LOCAL-CONTROL, TCD50 AND DOSE-TIME PRESCRIPTION HABITS IN RADIOTHERAPY OF HEAD AND NECK TUMORS
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DOI：
10.1016/0167-8140(94)90018-3
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发表时间：
1994-09-01
影响因子：
5.7
通讯作者：
DUBBEN, HH
中科院分区：
文献类型：
--
作者：
DUBBEN, HH
由Withers等人提供的头颈部肿瘤的临床数据（放疗期间加速肿瘤克隆原再生的危害）。医学学报，27:131-146,1988)。最近有研究认为TCD50与治疗时间的关系可能受到处方实践的影响[3,4]。本文探讨了局部肿瘤控制率在数据解释中的作用。在真实数据集中，局部肿瘤控制率用肿瘤失败率或随机数代替。TCD50值根据原始数据和这些经过处理的数据计算，并与治疗时间有关。TCD50在所有病例中均增加约0.48 Gy/d。这一意想不到的结果是由于缺乏剂量-反应关系，导致TCD50与处方剂量之间存在高度显著的相关性。与此一致，多元回归分析显示处方剂量对TCD50有显著影响（p < 0.0001），但对治疗时间无显著影响（p < 0.05）。TCD50随治疗时间的增加仅反映了剂量-时间处方习惯。这些数据没有提供明显的证据表明治疗时间或头颈部肿瘤放疗期间再繁殖的影响。根据缺乏证据，可能不能得出治疗时间是放疗中一个不重要的参数的结论。
Clinical data on head and neck tumours presented by Withers et al. (The hazard of accelerated tumour clonogen repopulation during radiotherapy. Acta Oncol. 27: 131-146, 1988) are reexamined. Recently it was argued that the relationship between TCD50 and treatment time might be influenced by the practice of prescription [3,4]. This paper investigates the role of local tumour control rate in the interpretation of the data. In the genuine data set local tumour control rates were replaced by either tumour failure rate or by random numbers. TCD50 values were calculated from the original and these manipulated data and related to treatment duration. TCD50 increases with about 0.48 Gy/day in all cases. This unexpected result is explained by the lack of a dose-response relationship which causes a highly significant correlation between TCD50 and prescribed dose. Consistently, multiple regression analysis reveals a significant impact of prescribed dose (p < 0.0001) on TCD50 but not of treatment duration (p > 0.05). The increase of TCD50 with treatment time reflects solely dose-time prescription habits. The data provide no significant evidence either for an impact of treatment duration or for repopulation during radiotherapy in head and neck tumours. From this lack of evidence it may not be concluded that treatment duration is an unimportant parameter in radiotherapy.