Problems and advances in the dosimetry of radionuclide targeted therapy.

Problems and advances in the dosimetry of radionuclide targeted therapy.
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放射性核素靶向治疗剂量测定的问题与进展。

DOI:
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发表时间:
1996
期刊:
Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer
影响因子:
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通讯作者:
J. Humm
J. Humm
中科院分区:
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文献类型:
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作者:
J. Humm

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传统的外部射束放射治疗的目标之一是构建治疗计划,其中跨肿瘤的剂量分布是均匀的。这可以在肿瘤剂量异质性小于15%的情况下实现。因此,剂量反应和肿瘤控制概率(TCP)的概念,在外部束治疗是明确的定义和明确的。然而,在放射疗法中对许多疾病部位的治疗导致正常组织结构的部分体积的高剂量。例如,在胰腺癌的治疗中,胰腺的位置导致不可避免地向肾脏和脊髓输送高剂量。脊髓的辐射耐受性是众所周知的。它的行为符合辐射损伤的系列模型,这意味着脊髓任何区域的剂量超过50戈伊都可能产生横向辐射脊髓炎。然而,肾脏的反应是根据平行模型,即,肾由大量重复单位肾单位组成,在观察到肾功能丧失之前,必须破坏其中的一部分。胰腺癌治疗计划的目标是操纵射束方向和权重,以最大限度地减少接受高剂量辐照的肾脏体积,从而降低肾脏并发症的风险,与靶体积的处方剂量一致,脊髓任何部位的剂量为003 C;45戈伊。
One of the goals of conventional external beam radiotherapy is to construct treatment plans for which the dose distribution across the tumor is uniform. This can be achieved with tumor dose heterogeneities of less than 15%. Therefore the concepts of dose response and tumor control probability (TCP) in external beam therapy are clearly defined and unambiguous. However, the treatment of many disease sites in radiation therapy result in high doses to partial volumes of normal tissue structures. For example, in the treatment of pancreatic cancer, the location of the pancreas results in the unavoidable delivery of high doses to the kidneys and spinal cord. The radiation tolerance of the spinal cord is well known. It behaves according to a serial model of radiation damage, which means that a dose in excess of 50 Gy to any region of the spinal cord can produce transverse radiation myelitis. However, the response of kidney is according to a parallel model, i.e., the kidney consists of a large number of repeat units, nephrons, a certain fraction of which must be destroyed before loss of kidney function is observed. The objective of a treatment plan for pancreatic cancer is to manipulate the beam directions and weights, so as to minimize the volume of kidney receiving high dose irradiation in order to reduce the risk of kidney complication, consistent with the prescribed dose to the target volume, and a dose of 003C;45 Gy anywhere to the spinal cord.
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