Hypoxia dose painting by numbers: A planning study
Hypoxia dose painting by numbers: A planning study
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DOI：
10.1016/j.ijrobp.2006.11.061
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发表时间：
2007-05-01
影响因子：
7
通讯作者：
Alber, Markus
中科院分区：
文献类型：
--
作者：
Thorwarth, Daniela;Eschmann, Susanne-Martina;Alber, Markus
目的：探讨不同的低氧剂量绘画策略在头颈部放疗的可行性，其潜在的好处是有限的规定等毒性相对于常规调强放疗（IMRT）treatment.Methods和材料：13头颈部肿瘤患者被纳入规划研究。对于每例患者，创建了三种不同的治疗计划：常规IMRT计划，氟脱氧葡萄糖（FDG）阳性体积的10%的额外均匀剂量递增（uniDE），以及实施数字剂量绘制（DPBN）的计划。根据从动态[F-18]-fluoromisonidazole（FMISO）正电子发射断层扫描data.Results计算的剂量递增因子图，实现了由数字绘制的剂量。对于DPBN，处方可以在比UNIDE更大的目标区域中实现。氟脱氧葡萄糖阳性体积的大小最大为94 cm（3）。相比之下，接受3种类似剂量水平DPBN的区域的体积范围为0-2.7 cm。在大多数情况下，观察到uniDE对靶点的过度治疗，而某些区域未接受所需剂量以克服缺氧诱导的辐射不敏感性。患者组中肿瘤控制概率从常规IMRT的55.9%增加到uniDE方法的57.7%。对于DPBN，确定肿瘤控制概率从55.9%潜在增加至70.2%。因此，DPBN似乎导致更高的效益为patient.Conclusion：剂量绘画的数字提供了更有效的剂量比一个额外的均匀的提升到FDG阳性区域。如果缺氧可以充分量化与一个简单的成像技术，如FMISO正电子发射断层扫描，DPBN在头颈癌可以大大提高肿瘤控制。(c)2007爱思唯尔公司
Purpose: To investigate the feasibility of different hypoxia dose painting strategies in head-and-neck radiotherapy; the potential benefit was limited by the stipulation of isotoxicity with respect to the conventional intensity-modulated radiotherapy (IMRT) treatment.Methods and Materials: Thirteen head-and-neck cancer patients were included into the planning study. For each patient, three different treatment plans were created: a conventional IMRT plan, an additional uniform dose escalation (uniDE) of 10% to the fluorodeoxyglucose (FDG)-positive volume, and a plan in which dose painting by numbers (DPBN) was implemented. Dose painting by numbers was realized according to a map of dose-escalation factors calculated from dynamic [F-18]-fluoromisonidazole (FMISO) positron emission tomography data.Results: Both dose-escalation approaches were shown to be feasible under the constraint of limiting normal tissue doses to the level of conventional IMRT. For DPBN, the prescriptions could be fulfilled in larger regions of the target than for uniDE. Fluorodeoxyglucose-positive volumes had sizes up to 94 cm(3). In contrast, regions receiving 3 comparable dose levels with DPBN presented volumes in the range of 0-2.7 cm. Overtreatment of the target was observed with uniDE in most of the cases, whereas some regions did not receive the required dose to overcome hypoxia-induced radiation insensitivity. Tumor control probability increased from 55.9% with conventional IMRT to 57.7% for the uniDE method in the patient group. For DPBN, a potential increase in tumor control probability from 55.9% to 70.2% was determined. Therefore, DPBN seems to result in higher benefits for the patients.Conclusion: Dose painting by numbers delivers the dose more effectively than an additional uniform boost to the FDG-positive area. If hypoxia could be adequately quantified with a simple imaging technique like FMISO positron emission tomography, DPBN in head-and-neck cancer could substantially increase tumor control. (c) 2007 Elsevier Inc.