针对 T1-T2 期和 T3-T4 期鼻咽癌患者的海马区疏散调强放射治疗剂量评估

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2024-09-27 DOI:10.1016/j.adro.2024.101646

Xiaofeng Zhou MD , Kui Wu MPhys , Niharika Prasad BDS , Sanjay Jaiswal PhD , Biao Jiang , Xia Li MPhys , Wenzheng Sun PhD , Lingli Mao PhD , Kanghua Huang PhD , Minghan Shi PhD , Shen Li , Qichun Wei MD, PhD

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引用次数: 0

摘要

目的比较T1-T2期和T3-T4期鼻咽癌（NPC）患者在保留海马体（HPC）的调强放射治疗（IMRT）计划中减少的海马体（HPC）剂量，并研究HPC剂量与PTVnx70体积（鼻咽原发肿瘤接受70 Gy的计划目标体积）之间的相关性。根据鼻咽癌的治疗方案，为每位患者设计了不保留 HPC 的 IMRT 或保留 HPC 的 IMRT。剂量-体积直方图用于评估每位患者的 IMRT 方案。比较了T1-T2期组和T3-T4期组的HPC参数值（如Dmin[NS] - Dmin[S]）在HPC保留方案和非保留方案之间的差异。分析了 HPC 剂量与 PTVnx70 体积之间的相关性。与不保留 HPC 的计划相比，保留 HPC 的计划显著降低了 HPC 的剂量学和体积参数（P <.05），但 Dmin、D98% 和 V5 除外。T1-T2组的Dmedian[NS] - Dmedian[S]、Dmean[NS] - Dmean[S]、D40%[NS] - D40%[S]、V30[NS] - V30[S]、V40[NS] - V40[S]和V50[NS] - V50[S]的中位数分别明显低于T3-T4组（P < .05）。在保全 HPC 和不保全 HPC 的计划中，HPC 的剂量学参数和体积参数均与 PTVnx70 体积呈正相关（P < .05）。PTVnx70的体积与Dmedian[NS] - Dmedian[S]、Dmean[NS] - Dmean[S]、D40%[NS] - D40%[S]、V40[NS] - V40[S]和V50[NS] - V50[S]呈正相关（P < .05）。结论与 T1-T2 期患者相比，保全 HPC IMRT 方案在降低 T3-T4 期鼻咽癌患者 HPC 的 Dmedian、Dmean、D40% 和 V30-V50 方面可能发挥更显著的作用。鼻咽癌患者的PTVnx70容积与HPC的所有剂量学和容积参数以及HPC保全IMRT计划对特定剂量参数的降低呈正相关。

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Dosimetric Evaluation of Hippocampus Sparing Intensity Modulated Radiation Therapy in Patients With Stage T1-T2 and Stage T3-T4 Nasopharyngeal Carcinoma

Purpose

To compare the hippocampus (HPC) dose reduced by HPC-sparing intensity modulated radiation therapy (IMRT) plans between nasopharyngeal carcinoma (NPC) patients of stages T1-T2 and T3-T4, and to investigate the correlation between the dose of the HPC and the volume of PTV_nx70 (the planning target volume of the primary tumor in the nasopharynx that received 70 Gy).

Methods and Materials

Fifty-eight NPC patients were retrospectively evaluated. HPC-nonsparing IMRT or sparing IMRT for each patient was designed according to the protocol for NPC. Dose-volume histogram was used to evaluate the IMRT plans for each patient. The difference in values of HPC parameters (eg, D_min[NS] – D_min[S]) between HPC-sparing and nonsparing plans in the stage T1-T2 group and stage T3-T4 group were compared. The correlations between the dose of the HPC and the volume of PTV_nx70 were analyzed.

Results

There was no significance between HPC-sparing and nonsparing IMRT plans. Compared with the HPC-nonsparing plans, the HPC-sparing plans significantly decreased both dosimetric and volumetric parameters for the HPC (P < .05), except for D_min, D_98%, and V₅. The medians of D_median[NS] – D_median[S], D_mean[NS] – D_mean[S], D_40%[NS] – D_40%[S], V₃₀[NS] – V₃₀[S], V₄₀[NS] – V₄₀[S] and V₅₀[NS] – V₅₀[S] in the T1-T2 group were significantly lower than in the T3-T4 group (P < .05), respectively. Both dosimetric and volumetric parameters for the HPC were positively correlated with the volume of PTV_nx70 in HPC-sparing and HPC-nonsparing plans (P < .05). The volume of PTV_nx70 was positively correlated with D_median[NS] – D_median[S], D_mean[NS] – D_mean[S], D_40%[NS] – D_40%[S], V₄₀[NS] – V₄₀[S] and V₅₀[NS] – V₅₀[S] (P < .05).

Conclusions

HPC-sparing IMRT plans may play a more significant role in decreasing D_median, D_mean, D_40%, and V₃₀-V₅₀ of HPC in NPC patients with stages T3-T4 than those in stages T1-T2. PTV_nx70 volume of NPC patients is positively correlated with all dosimetric and volumetric parameters of HPC and the reduction of specific dosage parameters by HPC-sparing IMRT plans.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.