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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Dosimetric predictors of chest wall pain after lung stereotactic body radiotherapy
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Dosimetric predictors of chest wall pain after lung stereotactic body radiotherapy

机译：肺立体定向放疗后胸壁疼痛的剂量学预测因子

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Purpose: To identify risk factors for the development of chest wall (CW) pain after thoracic stereotactic body radiotherapy (SBRT). Methods and materials: A registry of patients with lung lesions treated with lung SBRT was explored to identify patients treated with 54 Gy in three fractions or 50 Gy in five fractions. One hundred and forty-six lesions in 140 patients were identified; complete electronic treatment plans were available on 86 CWs. The CW was contoured as a 3 cm outward expansion from the involved lung. Univariate and multivariate analyses were used to correlate patient, tumor, and dosimetric factors to the development of CW toxicity. Results: CW pain occurred in 22 patients (15.7%). The Kaplan-Meier estimated risk of CW pain at 2 years was 20.1% (95% C.I., 13.2-28.8%). On univariate analysis of patient factors, elevated BMI (p = 0.026) and connective tissue disease (p = 0.036) correlated with CW pain. The percent of CW receiving 30, 35, or 40 Gy was most predictive of CW pain on multivariate analysis using logistic regression, while V40 alone was predictive using Cox regression. A V30 threshold of 0.7% and V40 threshold of 0.19% was correlated with a 15% risk of CW pain. Conclusions: We have described patient and dosimetric parameters that correlate with CW pain after lung SBRT. The risk of CW pain may be mitigated by attempting to reduce the relative proportion of CW receiving 30-40 Gy during treatment planning.
机译：目的：确定胸部立体定向放疗（SBRT）后胸壁（CW）疼痛发展的危险因素。方法和材料：对肺SBRT治疗的肺部病变患者的登记册进行了研究，以鉴定三部分使用54 Gy或五部分使用50 Gy的患者。共鉴定140例患者中的146个病变;完整的电子治疗计划可用于86个CW。 CW的轮廓是从受累肺向外扩展3厘米。使用单因素和多因素分析将患者，肿瘤和剂量学因素与CW毒性的发生联系起来。结果：22例患者发生了CW疼痛（15.7％）。 Kaplan-Meier估计2年时发生CW疼痛的风险为20.1％（95％C.I.，13.2-28.8％）。在对患者因素进行单因素分析时，BMI升高（p = 0.026）和结缔组织疾病（p = 0.036）与CW疼痛相关。在接受logistic回归的多变量分析中，接受30、35或40 Gy的CW百分比最能预测CW疼痛，而单独的V40可以通过Cox回归预测。 V30阈值为0.7％，V40阈值为0.19％与15％的CW疼痛风险相关。结论：我们描述了与肺SBRT后CW疼痛相关的患者和剂量参数。通过在治疗计划期间尝试减少接受30-40 Gy的CW的相对比例，可以减轻CW疼痛的风险。

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