Dynamics-Adapted Radiotherapy Dose (DARD) for Head and Neck Cancer Radiotherapy Dose Personalization.
Dynamics-Adapted Radiotherapy Dose (DARD) for Head and Neck Cancer Radiotherapy Dose Personalization.
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DOI：
10.3390/jpm11111124
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发表时间：
2021-11-01
影响因子：
--
通讯作者：
Enderling H
中科院分区：
文献类型：
--
作者：
Zahid MU;Mohamed ASR;Caudell JJ;Harrison LB;Fuller CD;Moros EG;Enderling H
标准治疗放射治疗（RT）剂量已被开发为一种一刀切的方法，旨在最大限度地提高整个人群的肿瘤控制率。虽然这导致了66-70戈伊头颈癌的高控制率，但这是在没有考虑患者异质性的情况下完成的。我们提出了一个框架，以估计个性化的RT剂量为个体患者，基于治疗前和早期的肿瘤体积动态-动态适应性放疗剂量（DDARD）。我们还介绍了一项计算机模拟试验的结果，该试验使用了来自Moffitt和MD安德森癌症中心的39例头颈部癌症患者的回顾性数据，这些患者在2-2.12戈伊的工作日接受了66-70戈伊RT。重复该试验，将DDARD限制在（54，82）戈伊之间，以测试更适度的剂量调整。DDARD估计范围为8 - 186戈伊，我们的计算机模拟试验估计，77%接受标准治疗的患者平均剂量为39戈伊，23%平均剂量为32戈伊。采用限制性剂量调整的计算机模拟试验估计，局部控制可提高> 10%。我们证明了使用早期治疗肿瘤体积动力学为剂量递增和递减提供剂量个性化和分层信息的可行性。这些结果表明，有可能降低大多数患者的病情，同时仍能提高人群水平的控制率。
Standard of care radiotherapy (RT) doses have been developed as a one-size-fits all approach designed to maximize tumor control rates across a population. Although this has led to high control rates for head and neck cancer with 66–70 Gy, this is done without considering patient heterogeneity. We present a framework to estimate a personalized RT dose for individual patients, based on pre- and early on-treatment tumor volume dynamics—a dynamics-adapted radiotherapy dose (DDARD). We also present the results of an in silico trial of this dose personalization using retrospective data from a combined cohort of n = 39 head and neck cancer patients from the Moffitt and MD Anderson Cancer Centers that received 66–70 Gy RT in 2–2.12 Gy weekday fractions. This trial was repeated constraining DDARD between (54, 82) Gy to test more moderate dose adjustment. DDARD was estimated to range from 8 to 186 Gy, and our in silico trial estimated that 77% of patients treated with standard of care were overdosed by an average dose of 39 Gy, and 23% underdosed by an average dose of 32 Gy. The in silico trial with constrained dose adjustment estimated that locoregional control could be improved by >10%. We demonstrated the feasibility of using early treatment tumor volume dynamics to inform dose personalization and stratification for dose escalation and de-escalation. These results demonstrate the potential to both de-escalate most patients, while still improving population-level control rates.
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DOI：
10.1016/s1470-2045(17)30252-8
发表时间：
2017-05
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Caudell JJ;Torres-Roca JF;Gillies RJ;Enderling H;Kim S;Rishi A;Moros EG;Harrison LB
通讯作者：
Harrison LB
影响因子：
10.3
作者：
Riaz, Nadeem;Sherman, Eric;Lee, Nancy
通讯作者：
Lee, Nancy
影响因子：
2.6
作者：
Sunassee, Enakshi D.;Tan, Dean;Enderling, Heiko
通讯作者：
Enderling, Heiko
影响因子：
78.8
作者：
Tursz, Thomas;Andre, Fabrice;Soria, Jean-Charles
通讯作者：
Soria, Jean-Charles
影响因子：
3.1
作者：
Mirghani, Haitham;Blanchard, Pierre
通讯作者：
Blanchard, Pierre