Recommendations from gynaecological (GYN) GEC ESTRO working group (II):: Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy -: 3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiotogy
Recommendations from gynaecological (GYN) GEC ESTRO working group (II):: Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy -: 3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiotogy
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DOI：
10.1016/j.radonc.2005.11.014
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发表时间：
2006-01-01
影响因子：
5.7
通讯作者：
Kirisits, C
中科院分区：
文献类型：
--
作者：
Pötter, R;Haie-Meder, C;Kirisits, C
GYN GEC ESTRO工作组建议的第二部分集中于宫颈癌近距离放射治疗的3D剂量-体积参数。方法和参数是根据不同机构(维也纳大学、巴黎IGR大学、鲁汶大学)的剂量学成像和临床经验开发和验证的。建议使用累积剂量体积直方图(DVH)来评估复杂剂量的不均匀。GTV、HR CTV和IR CTV的DVH参数分别为各自体积的90%和100%的最小剂量：D90、D100。该体积由规定剂量(V150、V200)的150%或200%包围，建议用于高剂量体积的总体评估。建议仅在给定的治疗计划内进行质量评估。对于危险器官(OAR)，建议报告的最大照射组织体积的最小剂量：0.1、1和2厘米(3)；可选的5和10厘米(3)。潜在的假设是：在感兴趣的体积内进行全剂量外照射，在分次近距离治疗期间相同的位置，连续体积和器官壁轮廓2厘米(3)。剂量值报告为吸收剂量，并考虑到不同的剂量率。线性二次放射生物学模型-等效剂量(EQD(2))-用于近距离放射治疗，也用于计算外照射剂量。这种形式主义允许在一个患者、一个中心内进行系统评估，并通过分析GTV、CTV和OAR的剂量体积关系在不同中心之间进行比较。提出了从传统的基于图像的宫颈癌近距离放射治疗向3D图像近距离放射治疗过渡的建议。补充数据(可在本文的电子版中获得)涉及GTV和CTV的3D成像、辐射物理、辐射生物学、参考点的剂量以及尺寸和体积(添加到[Haie-Meder C，Potter R，Van Limbergen E et al.妇科(GYN)GEC ESTRO工作组的建议(1)：宫颈癌近距离放射治疗中基于3D图像的3D治疗计划的概念和术语，重点是GTV和CTV的MRI评估。Radither Onol 2005；74：235-245])。如果在考虑到OAR的剂量体积限制的情况下，将辐射剂量规定为3D图像偏向的CTV，预计可以显著提高治疗比率，包括靶点覆盖和危险器官的保留。然而，这些建议在临床上的前瞻性应用是有必要的，以进一步探索和发展基于3D图像的宫颈癌近距离放射治疗的潜力。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
The second part of the GYN GEC ESTRO working group recommendations is focused on 3D dose-volume parameters for brachytherapy of cervical carcinoma. Methods and parameters have been developed and validated from dosimetric imaging and clinical experience from different institutions (University of Vienna, IGR Paris, University of Leuven).Cumulative dose volume histograms (DVH) are recommended for evaluation of the complex dose heterogeneity. DVH parameters for GTV, HR CTV and IR CTV are the minimum dose delivered to 90 and 100% of the respective volume: D90, D100. The volume, which is enclosed by 150 or 200% of the prescribed dose (V150, V200), is recommended for overall assessment of high dose volumes. V100 is recommended for quality assessment only within a given treatment schedule. For Organs at Risk (OAR) the minimum dose in the most irradiated tissue volume is recommended for reporting: 0.1, 1, and 2 cm(3); optional 5 and 10 cm(3). Underlying assumptions are: full dose of external beam therapy in the volume of interest, identical location during fractionated brachytherapy, contiguous volumes and contouring of organ walls for > 2 cm(3). Dose values are reported as absorbed dose and also taking into account different dose rates. The linear-quadratic radiobiological model-equivalent dose (EQD(2))-is applied for brachytherapy and is also used for calculating dose from external beam therapy. This formalism allows systematic assessment within one patient, one centre and comparison between different centres with analysis of dose volume relations for GTV, CTV, and OAR.Recommendations for the transition period from traditional to 3D image-based cervix cancer brachytherapy are formulated. Supplementary data (available in the electronic version of this paper) deals with aspects of 3D imaging, radiation physics, radiation biology, dose at reference points and dimensions and volumes for the GTV and CTV (adding to [Haie-Meder C, Potter R, Van Limbergen E et al. Recommendations from Gynaecological (GYN) GEC ESTRO Working Group (1): concepts and terms in 3D image-based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol 2005;74:235-245]).It is expected that the therapeutic ratio including target coverage and sparing of organs at risk can be significantly improved, if radiation dose is prescribed to a 3D image-biased CTV taking into account dose volume constraints for OAR. However, prospective use of these recommendations in the clinical context is warranted, to further explore and develop the potential of 3D image-based cervix cancer brachytherapy. (c) 2005 Elsevier Ireland Ltd. All rights reserved.