Dose-volumetric parameters predicting radiation-induced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with three-dimensional conformal radiotherapy
Dose-volumetric parameters predicting radiation-induced hepatic toxicity in unresectable hepatocellular carcinoma patients treated with three-dimensional conformal radiotherapy
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DOI：
10.1016/j.ijrobp.2006.08.015
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发表时间：
2007-01-01
影响因子：
7
通讯作者：
Kim, Chang-Min
中科院分区：
文献类型：
--
作者：
Kim, Tae Hyun;Kim, Dae Yong;Kim, Chang-Min
目的：为了确定剂量体积参数与放射性肝毒性（RIHT）的风险，在肝细胞癌患者治疗与三维适形radiotherapy.Methods和Materials：共105例肝细胞癌患者进行了三维适形放疗（总剂量范围，44-58.5戈伊，中位数，54）。在完成三维适形放疗后4个月内对RIHT进行评分。分析的剂量-体积参数是大体肿瘤体积;正常肝脏体积;总肝脏体积;辐射剂量;正常肝脏的平均剂量;接受>= 20、>= 25、>= 30、>= 35和> 40戈伊的正常肝脏体积的百分比;结果：1.接受>= 20、>= 25、>= 30、>= 35、>= 40戈伊照射的肝总体积百分比及正常组织并发症的概率。在105例患者中，21例（20.0%）患者观察到I级RIHT，7例（6.7%）患者观察到2级RIHT，5例（4.8%）患者观察到3级RIHT，1例（1.0%）患者观察到4级RIHT。未发生致死性5级RIHT。在预测2级或更差RIHT的多变量分析中，接受30戈伊的总肝脏体积是唯一有意义的参数（p < 0.001）。在接受30戈伊照射的85例患者中，仅2例（2.4%）观察到2级或更严重的RIHT（P < 0.001）。结论：接受≥ 30戈伊照射的总肝体积是预测RIHT风险的一个有用的剂量-体积参数。此卷应限于
Purpose: To identify the dose-volumetric parameters associated with the risk of radiation-induced hepatic toxicity (RIHT) in hepatocellular carcinoma patients treated with three-dimensional conformal radiotherapy.Methods and Materials: A total of 105 hepatocellular carcinoma patients underwent three-dimensional conformal radiotherapy(total dose range, 44-58.5 Gy; median, 54). RIHT was scored within 4 months of completing three-dimensional conformal radiotherapy. The dose-volume parameters analyzed were the gross tumor volume; normal liver volume; total liver volume; radiation dose; mean dose to the normal liver; percentage of the normal liver volume receiving >= 20, >= 25, >= 30, >= 35, and > 40 Gy; percentage of the total liver volume receiving >= 20, >= 25, >= 30, >= 35, and >= 40 Gy; and the normal tissue complication probability.Results: Of the 105 patients, Grade I RIHT was observed in 21 (20.0%), Grade 2 in 7 (6.7%), Grade 3 in 5 (4.8%), and Grade 4 in 1 (1.0%) patient. No fatal Grade 5 RIHT developed. On multivariate analysis for predicting Grade 2 or worse RIHT, the total liver volume receiving 30 Gy was the only significant parameter (p < 0.001). Grade 2 or worse RIHT was observed in only 2 (2.4%) of 85 patients with a total liver volume receiving 30 Gy of 60% (p < 0.001).Conclusion: The total liver volume receiving >= 30 Gy appears to be a useful dose-volumetric parameter for predicting the risk of RIHT. This volume should be limited to