Dose painting by numbers based on retrospectively determined recurrence probabilities
Dose painting by numbers based on retrospectively determined recurrence probabilities
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DOI：
10.1016/j.radonc.2016.09.007
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发表时间：
2017-02-01
影响因子：
5.7
通讯作者：
Ahnesjo, Anders
中科院分区：
文献类型：
--
作者：
Gronlund, Eric;Johansson, Silvia;Ahnesjo, Anders
背景和目的：本研究的目的是从回顾性观察到的复发量与常规放疗治疗头颈部鳞状细胞癌的患者组中获得“剂量绘画的数字”处方材料和方法：回顾性观察到的复发量和治疗前的标准化摄取值（SUV）从氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）成像之间的空间关系进行了测定。基于这些信息，我们推导出SUV驱动的剂量反应函数，并使用这些优化理想的剂量再分布的约束下，平均剂量的肿瘤体积作为一个传统的治疗。响应函数也被实现到一个治疗计划系统中，以实现现实的剂量优化。结果：计算出的肿瘤控制概率（TCP）增加了0.1-14.6%之间的理想剂量重新分配的所有纳入患者，其中患者与较大的和更异质的肿瘤比较小的和更同质的肿瘤得到更大的增加。剂量涂抹处方可以从回顾性观察的复发体积与治疗前FDG-PET图像数据的空间关系中导出。理想的剂量再分布可以显著增加肿瘤体积大和SUV中FDG-PET扩散大的患者的TCP。该结果为前瞻性研究确定头颈部鳞状细胞癌剂量涂绘的临床价值奠定了基础。(C)2016作者出版社：Elsevier爱尔兰Ltd.
Background and purpose: The aim of this study is to derive "dose painting by numbers" prescriptions from retrospectively observed recurrence volumes in a patient group treated with conventional radiotherapy for head and neck squamous cell carcinoma.Materials and methods: The spatial relation between retrospectively observed recurrence volumes and pre-treatment standardized uptake values (SUV) from fluorodeoxyglucose positron emission tomography (FDG-PET) imaging was determined. Based on this information we derived SUV driven dose-response functions and used these to optimize ideal dose redistributions under the constraint of equal average dose to the tumor volumes as for a conventional treatment. The response functions were also implemented into a treatment planning system for realistic dose optimization.Results: The calculated tumor control probabilities (TCP) increased between 0.1-14.6% by the ideal dose redistributions for all included patients, where patients with larger and more heterogeneous tumors got greater increases than smaller and more homogeneous tumors.Conclusions: Dose painting prescriptions can be derived from retrospectively observed recurrence volumes spatial relation to pre-treatment FDG-PET image data. The ideal dose redistributions could significantly increase the TCP for patients with large tumor volumes and large spread in SUV from FDG-PET. The results yield a basis for prospective studies to determine the clinical value for dose painting of head and neck squamous cell carcinomas. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.