On Voxel based Iso-Tumor Control Probabilty and Iso-Complication Maps for Selective Boosting and Selective Avoidance Intensity Modulated Radiotherapy.
On Voxel based Iso-Tumor Control Probabilty and Iso-Complication Maps for Selective Boosting and Selective Avoidance Intensity Modulated Radiotherapy.
复制标题
DOI：
10.1111/j.1617-0830.2008.00118.x
复制
发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Tome, Wolfgang A
中科院分区：
文献类型：
--
作者：
Kim, Yusung;Tome, Wolfgang A
基于体素的等肿瘤控制概率（TCP）图和等并发症图被提出作为一种计划审查工具，特别是用于功能图像引导的调强放疗（IMRT）策略，如选择性增强（剂量涂绘）和适形回避IMRT。该地图采用基于体素的现象学生物学剂量反应模型，用于靶体积和正常器官。研究了前列腺癌的两种IMRT策略，即向整个PTV传递EUD = 84 Gy（等效均匀剂量）的常规均匀IMRT和向整个PTV传递EUD = 82 Gy的选择性增强，以说明该方法相对于等剂量图的优势。传统的均匀IMRT确实产生了整个PTV更均匀的等剂量图，而选择性增强确实导致了不均匀的等剂量图。然而，与传统的均匀IMRT相比，当采用基于体素的iso-TCP图时，选择性增强显示出更均匀的肿瘤控制概率图，尽管对整个PTV提供了更高的EUD，但在高危肿瘤亚体积中显示了TCP冷点。提出了基于体素的直肠和膀胱等并发症图，并讨论了它们在选择性避免IMRT策略中的应用。我们相信，随着对功能图像引导治疗计划需求的增长，基于体素的iso-TCP和iso-并发症地图将成为评估此类治疗计划完整性的重要工具。
Voxel based iso-Tumor Control Probability (TCP) maps and iso-Complication maps are proposed as a plan-review tool especially for functional image-guided intensity-modulated radiotherapy (IMRT) strategies such as selective boosting (dose painting) and conformal avoidance IMRT. The maps employ voxel-based phenomenological biological dose-response models for target volumes and normal organs. Two IMRT strategies for prostate cancer, namely conventional uniform IMRT delivering an EUD = 84 Gy (equivalent uniform dose) to the entire PTV and selective boosting delivering an EUD = 82 Gy to the entire PTV, are investigated, to illustrate the advantages of this approach over iso-dose maps. Conventional uniform IMRT did yield a more uniform isodose map to the entire PTV while selective boosting did result in a nonuniform isodose map. However, when employing voxel based iso-TCP maps selective boosting exhibited a more uniform tumor control probability map compared to what could be achieved using conventional uniform IMRT, which showed TCP cold spots in high-risk tumor subvolumes despite delivering a higher EUD to the entire PTV. Voxel based iso-Complication maps are presented for rectum and bladder, and their utilization for selective avoidance IMRT strategies are discussed. We believe as the need for functional image guided treatment planning grows, voxel based iso-TCP and iso-Complication maps will become an important tool to assess the integrity of such treatment plans.