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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 (NTCP) parameters for breast fibrosis: Pooled results from two randomised trials
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Normal tissue complication probability (NTCP) parameters for breast fibrosis: Pooled results from two randomised trials

机译：乳腺纤维化的正常组织并发症概率（NTCP）参数：两项随机试验的汇总结果

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Introduction The dose-volume effect of radiation therapy on breast tissue is poorly understood. We estimate NTCP parameters for breast fibrosis after external beam radiotherapy. Materials and methods We pooled individual patient data of 5856 patients from 2 trials including whole breast irradiation followed with or without a boost. A two-compartment dose volume histogram model was used with boost volume as the first compartment and the remaining breast volume as second compartment. Results from START-pilot trial (n = 1410) were used to test the predicted models. Results 26.8% patients in the Cambridge trial (5 years) and 20.7% patients in the EORTC trial (10 years) developed moderate-severe breast fibrosis. The best fit NTCP parameters were BEUD3(50) = 136.4 Gy, γ50 = 0.9 and n = 0.011 for the Niemierko model and BEUD 3(50) = 132 Gy, m = 0.35 and n = 0.012 for the Lyman Kutcher Burman model. The observed rates of fibrosis in the START-pilot trial agreed well with the predicted rates. Conclusions This large multi-centre pooled study suggests that the effect of volume parameter is small and the maximum RT dose is the most important parameter to influence breast fibrosis. A small value of volume parameter 'n' does not fit with the hypothesis that breast tissue is a parallel organ. However, this may reflect limitations in our current scoring system of fibrosis.
机译：简介放射治疗对乳房组织的剂量-体积效应了解甚少。我们估计外部束放射治疗后乳腺纤维化的NTCP参数。材料和方法我们汇总了2项试验中的5856例患者的个体患者数据，包括全乳照射，有无增强。使用两室剂量体积直方图模型，其中增强体积为第一室，其余乳房体积为第二室。 START-pilot试验（n = 1410）的结果用于测试预测模型。结果剑桥试验（5年）中有26.8％的患者和EORTC试验（10年中）的20.7％的患者发展为中度-重度乳腺纤维化。对于Niemierko模型，最佳拟合NTCP参数为BEUD3（50）= 136.4 Gy，γ50= 0.9和n = 0.011，对于Lyman Kutcher Burman模型，BEUD 3（50）= 132 Gy，m = 0.35和n = 0.012 START-试点试验中观察到的纤维化发生率与预测的发生率非常吻合。结论这项大型的多中心汇总研究表明，体积参数的影响很小，最大RT剂量是影响乳腺纤维化的最重要参数。体积参数“ n”的较小值与乳房组织是平行器官的假设不符。但是，这可能反映了我们目前的纤维化评分系统的局限性。

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