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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Predictors of acute bowel toxicity in patients treated with IMRT whole pelvis irradiation after prostatectomy.
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Predictors of acute bowel toxicity in patients treated with IMRT whole pelvis irradiation after prostatectomy.

机译：前列腺切除术后接受IMRT全骨盆照射治疗的患者急性肠毒性的预测指标。

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PURPOSE/OBJECTIVE: Whole pelvis irradiation with IMRT (WPRT-IMRT) after prostatectomy is efficient in reducing acute toxicity: however, a number of patients still experience moderate acute bowel toxicity. MATERIALS AND METHODS: Ninety-six patients treated with WPRT-IMRT after prostatectomy with adjuvant or salvage intent were analysed. A number of parameters were individually recovered, including the DVHs of the intestinal cavity outside PTV and of the loops referred to both the WPRT phase and the whole treatment. Correlation between clinical-dosimetric parameters and acute bowel toxicity was investigated by logistic analyses. Best predictive cut-off values for continuous variables were assessed by ROC curves. RESULTS: 15/96 (15.6%) Patients experienced grade 2 toxicity (no grade 3). Best dose-volume predictors were the fraction of loops receiving more than 45, 50 and 55 Gy (respectively, V45TL >/= 50cc, V50TL >/= 13cc, V55TL >/= 3cc; p-values ranging from 0.005 to 0.027). Age, GU acute toxicity, rectal acute toxicity and time between prostatectomy and IMRT were also predictors of acute bowel toxicity. Multivariate analysis showed that the most predictive independent parameters were age (OR: 1.13; 95%CI: 1.02-1.25; p=0.021) and V50TL (>/= 13cc, OR: 8.2; 95%CI: 1.7-40; p=0.009). CONCLUSIONS: The risk of moderate acute uGI toxicity during WPRT-IMRT for post-operatively treated patients increases with age; the risk is substantially reduced in patients with small overlap between PTV and loops.
机译：目的/目的：前列腺切除术后用IMRT（WPRT-IMRT）进行全盆腔放射能有效降低急性毒性：但是，许多患者仍遭受中度急性肠毒性。材料与方法：分析了前列腺切除术后有辅助或抢救意图的WPRT-IMRT治疗的96例患者。单独恢复了许多参数，包括PTV外部肠腔的DVH和WPRT阶段以及整个治疗的循环。通过逻辑分析研究了临床剂量参数与急性肠毒性之间的相关性。通过ROC曲线评估连续变量的最佳预测临界值。结果：15/96（15.6％）患者经历2级毒性（无3级）。最佳剂量体积预测指标是接受大于45、50和55 Gy的环的比例（分别为V45TL> / = 50cc，V50TL> / = 13cc，V55TL> / = 3cc; p值范围为0.005至0.027）。年龄，GU急性毒性，直肠急性毒性以及前列腺切除术和IMRT之间的时间也是急性肠毒性的预测指标。多变量分析显示，最可预测的独立参数是年龄（OR：1.13; 95％CI：1.02-1.25; p = 0.021）和V50TL（> / = 13cc，OR：8.2; 95％CI：1.7-40; p = 0.009）。结论：WPRT-IMRT期间接受手术治疗的患者中度急性uGI毒性的风险随着年龄的增长而增加。 PTV和环路之间重叠很小的患者的风险大大降低。

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