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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Treatment margins and treatment fractionation in conformal radiotherapy of muscle-invading urinary bladder cancer.
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Treatment margins and treatment fractionation in conformal radiotherapy of muscle-invading urinary bladder cancer.

机译：侵袭性膀胱膀胱癌的适形放疗中的治疗余量和治疗分级。

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BACKGROUND AND PURPOSE: Different treatment margins and fractionation schedules are used in conformal radiotherapy (CRT) of urinary bladder cancer. This study compared intestine and rectum dose-volume histogram (DVH) data and normal tissue complication probability (NTCP) estimates for various clinically applied margins and fractionation schedules in bladder irradiation. PATIENTS AND METHODS: Normal tissue dose distributions in fifteen bladder cancer patients treated with CRT were studied using standard three- and four-field configurations. The impact of margin width on intestine and rectum dose distributions was initially evaluated using DVH data. NTCP modelling with the probit model was used to compare the impact of choice of margin size and fractionation schedule. The analysis included margin combinations of 1.0 cm isotropic (narrow margins) and 1.2-2.0 cm non-isotropic (wide margins) and fractionation schedule alternatives of 52.5Gy/20, 55Gy/20, 57.5Gy/20 and 64Gy/32. RESULTS: Using wide as comparedto narrow margins, the volumes of intestine and rectum receiving high doses increased by factors of approximately two and four, respectively. Similar differences between wide and narrow margins were found when calculating intestine and rectum NTCPs. The impact of margin size depended strongly on the volume effect expressed by the NTCP model parameters. With standard parameters, however, the choice of margins and fractionation schedule had a similar impact on intestine NTCPs, while for the rectum, the choice of margin had a greater impact than the choice of fractionation. For a given margin size, the intestine and rectum NTCPs for the 55Gy/20 and the 64Gy/32 schedules were comparable. For clinics using narrow margins and a fractionation of 52.5Gy/20, the NTCP modelling suggested that a change in fractionation schedule (to 55Gy/20 or 64Gy/32) or a change to wide margins would have a similar effect on the intestine NTCP predictions. CONCLUSIONS: This modelling study documented that the choice of margins was as important as the choice of fractionation in terms of intestine and rectum DVH data and NTCP predictions.
机译：背景与目的：膀胱癌的适形放疗（CRT）中使用了不同的治疗余量和分级方案。这项研究比较了肠和直肠剂量体积直方图（DVH）数据和正常组织并发症概率（NTCP）估计值，以评估膀胱照射中各种临床应用的切缘和分馏方案。患者和方法：使用标准的三场和四场配置研究了15例接受CRT治疗的膀胱癌患者的正常组织剂量分布。边缘宽度对肠道和直肠剂量分布的影响最初是使用DVH数据评估的。使用NTCP与Probit模型进行建模，以比较选择边距大小和分馏计划的影响。分析包括1.0 cm各向同性（窄边距）和1.2-2.0 cm非各向同性（宽边距）的边距组合，以及52.5Gy / 20、55Gy / 20、57.5Gy / 20和64Gy / 32的分馏方案替代方案。结果：与狭窄的边缘相比，使用宽的边缘时，接受高剂量的肠和直肠的体积分别增加了大约2倍和4倍。计算肠和直肠NTCP时，在宽和窄边缘之间存在相似的差异。边距大小的影响在很大程度上取决于NTCP模型参数表示的体积效应。但是，使用标准参数，边距的选择和分级安排对肠道NTCP的影响相似，而对于直肠，裕度的选择比分级分离的影响更大。对于给定的保证金大小，针对55Gy / 20和64Gy / 32计划的肠和直肠NTCP相当。对于使用窄边距和分割为52.5Gy / 20的诊所，NTCP建模建议更改分割时间表（更改为55Gy / 20或64Gy / 32）或更改宽边距对肠道NTCP的预测具有相似的影响。结论：该建模研究证明，就肠和直肠DVH数据以及NTCP预测而言，选择切缘与选择切分同样重要。

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