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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Normal tissue complication probability modeling for acute esophagitis in patients treated with conformal radiation therapy for non-small cell lung cancer.
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Normal tissue complication probability modeling for acute esophagitis in patients treated with conformal radiation therapy for non-small cell lung cancer.

机译：非小细胞肺癌保形放射治疗患者急性食管炎的正常组织并发症概率模型。

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摘要

PURPOSE: To evaluate the ability of a well-known normal tissue complication probability (NTCP) model to predict radiation esophagitis by determining updated model parameters and then comparing these results with the predictive value of other dosimetric parameters. MATERIAL AND METHODS: Clinical and dosimetric data regarding esophagitis were analyzed in 101 inoperable/unresectable non-small-cell lung cancer patients treated by external beam irradiation. Grade 2 or higher esophagitis counted as events. Parameters (TD50, n, and m) of the Lyman normal tissue complication probability (NTCP) model were determined using maximum likelihood analysis, and compared to other dose/volume threshold values including: percentage of esophagus receiving > 40 Gy (V40) to > 75 Gy (V75), and maximum esophageal doses. RESULTS: Sixteen patients developed grade 2-3 acute esophagitis (no G4 or 5). The maximum likelihood analysis produced new Lyman model parameters of: TD50 = 51 Gy, n = 0.44 and m = 0.32. The mean NTCP value is significantly lower (P < 0.001) in the group of patients without esophagitis (13.5%) than with esophagitis (27.2%). The rates of esophagitis are 2.5, 7, 9 and 13.4%, respectively, when the NTCP values are <10%, <15%, <20% and <25%. A significant association is found between esophagitis and dose/volume parameters V40 (P = 0.001) to V70 (P = 0.024). CONCLUSIONS: New values of TD50, n and m offer a good description of the esophagitis distribution in our population. Compared to the use of this model with previously published parameters (associated with late toxicity) predictions of the model for acute esophagitis using the new parameters would indicate that, for a population of patients, the distribution of events as a function of uniform dose would occur with a lower mean uniform dose value (smaller TD50), over a wider range of uniform doses (larger m), while also exhibiting a bigger volume effect (larger n). These new parameter values are supported in essence by the correlations found for the dose/volume threshold parameters.
机译：目的：通过确定更新的模型参数，然后将这些结果与其他剂量参数的预测值进行比较，以评估众所周知的正常组织并发症概率（NTCP）模型预测放射性食管炎的能力。材料与方法：分析了101例不能接受手术/不能切除的非小细胞肺癌外照射患者的食管炎临床和剂量学数据。 2级或以上的食管炎被视为事件。使用最大似然分析确定莱曼正常组织并发症概率（NTCP）模型的参数（TD50，n和m），并将其与其他剂量/体积阈值进行比较，包括：食道接受> 40 Gy（V40）的百分比至> 75 Gy（V75）和最大食道剂量。结果：16例患者发生2-3级急性食管炎（无G4或5）。最大似然分析产生了新的Lyman模型参数：TD50 = 51 Gy，n = 0.44，m = 0.32。无食管炎的患者组（13.5％）的平均NTCP值显着低于有食管炎的患者（27.2％）（P <0.001）。当NTCP值<10％，<15％，<20％和<25％时，食管炎的发生率分别为2.5％，7％，9％和13.4％。发现食管炎与剂量/体积参数V40（P = 0.001）至V70（P = 0.024）之间存在显着相关性。结论：TD50，n和m的新值很好地描述了我们人群中食管炎的分布。与使用该模型与先前发布的参数（与晚期毒性相关）相比，使用新参数对急性食管炎模型的预测将表明，对于一组患者，事件的分布将随着均匀剂量而发生平均剂量值较低（TD50较小），均匀剂量范围较大（m较大）且体积效应也较大（n较大）。这些新的参数值实质上由针对剂量/体积阈值参数找到的相关性支持。

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