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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Prediction of rectum and bladder morbidity following radiotherapy of prostate cancer based on motion-inclusive dose distributions
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Prediction of rectum and bladder morbidity following radiotherapy of prostate cancer based on motion-inclusive dose distributions

机译：基于包括运动在内的剂量分布，对前列腺癌放疗后的直肠和膀胱发病率进行预测

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Background and purpose In radiotherapy (RT) of prostate cancer the key organs at risk (ORs) - the rectum and the bladder - display considerable motion, which may influence the dose/volume parameters predicting for morbidity. In this study we compare motion-inclusive doses to planned doses for the rectum and bladder and explore their associations with prospectively recorded morbidity. Materials and methods The study included 38 prostate cancer patients treated with hypo-fractionated image-guided intensity-modulated RT that had an average of nine repeat CT scans acquired during treatment. These scans were registered to the respective treatment planning CT (pCT) followed by a new dose calculation from which motion-inclusive dose distributions were derived. The pCT volumes, the treatment course averaged volumes as well as the planned and motion-inclusive doses were associated with acute and late morbidity (morbidity cut-off: ≥Grade 2). Results Acute rectal morbidity (observed in 29% of cases) was significantly associated with both smaller treatment course averaged rectal volumes (population median: 75 vs. 94 cm3) and the motion-inclusive volume receiving doses close to the prescription dose (2 Gy-equivalent dose of 76 Gy). Conclusion Variation in rectum and bladder volumes leads to deviations between planned and delivered dose/volume parameters that should be accounted for to improve the ability to predict morbidity following RT.
机译：背景和目的在前列腺癌的放射治疗（RT）中，处于危险中的关键器官（直肠和膀胱）表现出明显的运动，这可能会影响预测发病率的剂量/体积参数。在这项研究中，我们将包括运动的剂量与直肠和膀胱的计划剂量进行了比较，并探讨了它们与前瞻性记录的发病率的关系。材料和方法这项研究包括38位接受过低级图像引导的强度调制RT治疗的前列腺癌患者，这些患者在治疗期间平均进行了9次重复CT扫描。将这些扫描记录到相应的治疗计划CT（pCT），然后进行新的剂量计算，从中得出包括运动的剂量分布。 pCT量，治疗过程的平均量以及计划和包括运动在内的剂量均与急性和晚期发病率相关（发病率临界值：≥2级）。结果急性直肠疾病（在29％的病例中观察到）与较小的治疗过程平均直肠体积（人口中位数：75 vs. 94 cm3）以及接受接近处方剂量（2 Gy-等效剂量为76 Gy）。结论直肠和膀胱体积的变化会导致计划的和交付的剂量/体积参数之间出现偏差，应加以考虑，以提高RT后预测发病率的能力。

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