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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Partially wedged beams improve radiotherapy treatment of urinary bladder cancer.
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Partially wedged beams improve radiotherapy treatment of urinary bladder cancer.

机译：部分楔形光束改善了膀胱癌的放射治疗。

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BACKGROUND AND PURPOSE: Partially wedged beams (PWBs) having wedge in one part of the field only, can be shaped using dynamic jaw intensity modulation. The possible clinical benefit of PWBs was tested in treatment plans for muscle-infiltrating bladder cancer. MATERIAL AND METHODS: Three-dimensional treatment plans for 25 bladder cancer patients were analyzed. The originally prescribed standard conformal four-field box technique, which includes the use of lateral ordinary wedge beams, was compared to a modified conformal treatment using customized lateral PWBs. In these modified treatment plans, only the anterior parts of the two lateral beams had a wedge. To analyze the potential clinical benefit of treatment with PWBs, treatment plans were scored and compared using both physical parameters and biological dose response models. One tumour control probability model and two normal tissue complication probability (NTCP) models were applied. Different parameters for normal tissue radiation tolerance presented in the literature were used. RESULTS: By PWBs the dose homogeneity throughout the target volume was improved for all patients, reducing the average relative standard deviation of the target dose distribution from 2.3 to 1.8%. A consistent reduction in the maximum doses to surrounding normal tissue volumes was also found. The most notable improvement was demonstrated in the rectum where the volume receiving more than the prescribed tumour dose was halved. Treatment with PWBs would permit a target dose escalation of 2-6 Gy in several of the patients analyzed, without increasing the overall risk for complications. The number of patients suitable for dose escalation ranged from 3 to 15, depending on whether support from all or only one of the five applied NTCP model/parameter combinations were required in each case to recommend dose escalation. CONCLUSION: PWBs represent a simple dose conformation tool that may allow radiation dose escalation in the treatment of muscle-infiltrating urinary bladder tumours.
机译：背景和目的：可以使用动态钳口强度调制来成形仅在一个区域中具有楔形的部分楔形梁（PWB）。在肌肉浸润性膀胱癌的治疗计划中测试了PWBs的可能的临床益处。材料与方法：分析了25例膀胱癌患者的三维治疗方案。将最初规定的标准共形四场盒形技术（包括使用横向普通楔形梁）与使用定制横向PWB的改良共形处理进行了比较。在这些修改的治疗计划中，只有两个侧梁的前部具有楔形。为了分析PWBs治疗的潜在临床益处，对治疗计划进行了评分并使用物理参数和生物剂量反应模型进行了比较。应用一个肿瘤控制概率模型和两个正常组织并发症概率（NTCP）模型。使用了文献中提出的正常组织辐射耐受性的不同参数。结果：通过PWB，所有患者的整个目标体积的剂量均一性得到改善，目标剂量分布的平均相对标准偏差从2.3％降低到1.8％。还发现最大剂量对周围正常组织体积的一致降低。最显着的改善表现在直肠，其中接受超过规定肿瘤剂量的体积减半。 PWBs的治疗将使一些被分析的患者的目标剂量增加2-6 Gy，而不会增加并发症的总体风险。适用于剂量递增的患者人数为3至15，这取决于在每种情况下是否都需要来自所有应用的5种NTCP模型/参数组合中的一种或仅一种的建议来支持剂量递增。结论：PWBs是一种简单的剂量构象工具，在治疗肌肉浸润性膀胱肿瘤时，可允许放射剂量升高。

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