Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues.
Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues.
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DOI:
10.1016/j.ijrobp.2009.09.040
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发表时间:
2010-03-01
影响因子:
7
通讯作者:
Yorke, Ellen D.
中科院分区:
文献类型:
--
作者:
Bentzen, Soren M.;Constine, Louis S.;Deasy, Joseph O.;Eisbruch, Avi;Jackson, Andrew;Marks, Lawrence B.;Ten Haken, Randall K.;Yorke, Ellen D.
Advances in dose/volume/outcome (or normal tissue complication probability, NTCP) modeling since the seminal Emami paper from 1991 are reviewed. There has been some progress with an increasing number of studies on large patient samples with three-dimensional dosimetry. Nevertheless, NTCP models are not ideal. Issues related to the grading of side effects, selection of appropriate statistical methods, testing of internal and external model validity, and quantification of predictive power and statistical uncertainty, all limit the usefulness of much of the published literature. Synthesis (meta-analysis) of data from multiple studies is often impossible due to sub-optimal primary analysis, insufficient reporting and variations in the models and predictors analyzed. Clinical limitations to the current knowledge-base includes the need for more data on the effect of patient-related co-factors, interactions between dose-distribution and cytotoxic or molecular targeted agents, and the effect of dose fractions and overall treatment time in relation to non-uniform dose distributions. Research priorities for the next 5 to 10 years are proposed.
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