Dosimetric impact in the dose-volume histograms of rectal and vesical wall contouring in prostate cancer IMRT treatments
Dosimetric impact in the dose-volume histograms of rectal and vesical wall contouring in prostate cancer IMRT treatments
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DOI：
10.1016/j.rpor.2017.02.005
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发表时间：
2017-05-01
影响因子：
1.2
通讯作者：
Ruiz, Antonio
中科院分区：
文献类型：
--
作者：
Gomez, Laura;Andres, Carlos;Ruiz, Antonio
目的：本研究的主要目的是评价前列腺癌调强放射治疗的剂量-体积直方图的差异，其依据是将主要危险器官(直肠和膀胱)描绘为实体器官或勾画其外壁。背景：直肠和膀胱通常被描绘为实体器官，包括废物，这在实践中可能导致对不良反应风险的错误评估。材料和方法：对25例前列腺癌患者进行了回顾性研究。前列腺和精囊照射76.32Gy36次。除了将直肠和膀胱描绘为实体器官(包括其内容物)外，还描绘了直肠和膀胱壁，并对两组结构的剂量-体积直方图进行了分析。结果：数据分析显示，用于评估前列腺癌放射治疗毒性风险的主要参数存在统计学差异。与相应实体器官的剂量相比，直肠和膀胱壁受到的剂量更高。结论：基于等高线方法观察到的直肠和膀胱接收剂量的差异在反向计划治疗中可能获得更大的重要性，因为治疗计划系统优化了这些体积的剂量。因此，对于慢性毒性的剂量限制和风险评估，应该考虑这些结构的描绘方法来做出临床决策。(C)2017年大波兰癌症中心。作者：Elsevier Sp.ZO.O。版权所有。
Aim: The main purpose of this study was to evaluate the differences in dose-volume histograms of IMRT treatments for prostate cancer based on the delineation of the main organs at risk (rectum and bladder) as solid organs or by contouring their wall.Background: Rectum and bladder have typically been delineated as solid organs, including the waste material, which, in practice, can lead to an erroneous assessment of the risk of adverse effects.Materials and methods: A retrospective study was made on 25 patients treated with IMRT radiotherapy for prostate adenocarcinoma. 76.32 Gy in 36 fractions was prescribed to the prostate and seminal vesicles. In addition to the delineation of the rectum and bladder as solid organs (including their content), the rectal and bladder wall were also delineated and the resulting dose-volume histograms were analyzed for the two groups of structures.Results: Data analysis shows statistically significant differences in the main parameters used to assess the risk of toxicity of a prostate radiotherapy treatment. Higher doses were received on the rectal and bladder walls compared to doses received on the corresponding solid organs.Conclusions: The observed differences in terms of received doses to the rectum and bladder based on the method of contouring could gain greater importance in inverse planning treatments, where the treatment planning system optimizes the dose in these volumes. So, one should take into account the method of delineating of these structures to make a clinical decision regarding dose limitation and risk assessment of chronic toxicity. (C) 2017 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved.