TEMPORAL LOBE REACTIONS AFTER RADIOTHERAPY WITH CARBON IONS: INCIDENCE AND ESTIMATION OF THE RELATIVE BIOLOGICAL EFFECTIVENESS BY THE LOCAL EFFECT MODEL
TEMPORAL LOBE REACTIONS AFTER RADIOTHERAPY WITH CARBON IONS: INCIDENCE AND ESTIMATION OF THE RELATIVE BIOLOGICAL EFFECTIVENESS BY THE LOCAL EFFECT MODEL
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DOI：
10.1016/j.ijrobp.2010.03.001
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发表时间：
2011-07-01
影响因子：
7
通讯作者：
Schulz-Ertner, Daniela
中科院分区：
文献类型：
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作者：
Schlampp, Ingmar;Karger, Christian P.;Schulz-Ertner, Daniela
目的：确定中枢神经系统耐辐射肿瘤碳离子放射治疗（RT）后颞叶反应（TLR）发展的预测因素，并评估用于计算生物有效剂量的局部效应模型（LEM）的预测。方法与材料：本回顾性研究报告了2002年和2003年在德国达姆施塔特GSI接受碳离子照射的颅底脊索瘤和软骨肉瘤患者的死亡率。在此基础上计算了不同治疗方案的相对生物效应和剂量优化。分别于放疗后3、6、12个月及此后每年进行临床检查和磁共振成像（MRI）检查。MRI检测到的颞叶局部造影剂增强被认为是辐射诱发的TLR。分析59例患者118个颞叶的剂量-体积直方图，统计评估16个治疗相关因素和2个患者相关因素对TLR发生的预测价值。结果：中位随访时间为2.5年（范围0.3-6.6年）。年龄和施加于至少1cm(3)颞叶的最大剂量(D(max，V) (-) （1) (cm)3，剩余颞叶体积的最大剂量，不包括最高剂量的体积1cm3）被发现是TLR最重要的预测因子。计算了D(max，V) (-) (1) (cm)3的剂量响应曲线。5%和50%发生TLR概率的生物等效耐受剂量分别为68.8 +/- 3.3 Gy当量（GyE）和87.3 +/- 2.8 Gy当量（GyE）。结论：D(max，V) (-) (1) (cm)3可预测辐射诱发的TLR。获得的耐受剂量似乎与已发表的高适形光子和质子照射数据一致。基于LEM的预测，我们没有发现临床结果和预期之间的任何临床相关偏差。(C) 2011爱思唯尔公司
Purpose: To identify predictors for the development of temporal lobe reactions (TLR) after carbon ion radiation therapy (RT) for radiation-resistant tumors in the central nervous system and to evaluate the predictions of the local effect model (LEM) used for calculation of the biologically effective dose.Methods and Materials: This retrospective study reports the mu rates in patients with skull base chordomas and chondrosarcomas Irradiated with carbon ions at GSI, Darmstadt, Germany, in the years 2002 and 2003. Calculation of the relative biological effectiveness and dose optimization of treatment plans were performed on the basis of the LEM. Clinical examinations and magnetic resonance imaging (MRI) were performed at 3, 6, and 12 months after RT and annually thereafter. Local contrast medium enhancement in temporal lobes, as detected on MRI, was regarded as radiation-induced TLR. Dose-volume histograms of 118 temporal lobes in 59 patients were analyzed, and 16 therapy-associated and 2 patient-associated factors were statistically evaluated for their predictive value for the occurrence of TLR.Results: Median follow-up was 2.5 years (range, 0.3-6.6 years). Age and maximum dose applied to at least 1 cm(3) of the temporal lobe (D(max,V) (-) (1) (cm)3, maximum dose in the remaining temporal lobe volume, excluding the volume 1 cm3 with the highest dose) were found to be the most important predictors for TLR. Dose response curves of D(max,V) (-) (1) (cm)3 were calculated. The biologically equivalent tolerance doses for the 5% and 50% probabilities to develop TLR were 68.8 +/- 3.3 Gy equivalents (GyE) and 87.3 +/- 2.8 GyE, respectively.Conclusions: D(max,V) (-) (1) (cm)3 is predictive for radiation-induced TLR. The tolerance doses obtained seem to be consistent with published data for highly conformal photon and proton irradiations. We could not detect any clinically relevant deviations between clinical findings and expectations based on predictions of the LEM. (C) 2011 Elsevier Inc.