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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Use of fractional dose-volume histograms to model risk of acute rectal toxicity among patients treated on RTOG 94-06
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Use of fractional dose-volume histograms to model risk of acute rectal toxicity among patients treated on RTOG 94-06

机译：使用分数剂量-体积直方图模拟接受RTOG治疗的患者的急性直肠毒性风险94-06

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摘要

Background and purpose: For toxicities occurring during the course of radiotherapy, it is conceptually inaccurate to perform normal-tissue complication probability analyses using the complete dose-volume histogram. The goal of this study was to analyze acute rectal toxicity using a novel approach in which the fit of the Lyman-Kutcher-Burman (LKB) model is based on the fractional rectal dose-volume histogram (DVH). Materials and methods: Grade ≥2 acute rectal toxicity was analyzed in 509 patients treated on Radiation Therapy Oncology Group (RTOG) protocol 94-06. These patients had no field reductions or treatment-plan revisions during therapy, allowing the fractional rectal DVH to be estimated from the complete rectal DVH based on the total number of dose fractions delivered. Results: The majority of patients experiencing Grade ≥2 acute rectal toxicity did so before completion of radiotherapy (70/80 = 88%). Acute rectal toxicity depends on fractional mean rectal dose, with no significant improvement in the LKB model fit when the volume parameter differs from n = 1. The incidence of toxicity was significantly lower for patients who received hormone therapy (P = 0.024). Conclusions: Variations in fractional mean dose explain the differences in incidence of acute rectal toxicity, with no detectable effect seen here for differences in numbers of dose fractions delivered.
机译：背景与目的：对于放疗过程中发生的毒性，使用完整的剂量-体积直方图进行正常组织并发症概率分析在概念上是不准确的。这项研究的目的是使用一种新颖的方法来分析急性直肠毒性，其中Lyman-Kutcher-Burman（LKB）模型的拟合是基于分数直肠剂量-体积直方图（DVH）。材料和方法：对放射治疗肿瘤学组（RTOG）方案94-06治疗的509例患者的≥2级急性直肠毒性进行了分析。这些患者在治疗期间没有视野缩小或治疗计划修订的情况，因此可以根据所递送的剂量分数的总数，从完整的直肠DVH估算直肠DVH的分数。结果：大多数经历≥2级急性直肠毒性反应的患者是在放疗完成之前这样做的（70/80 = 88％）。急性直肠毒性取决于直肠平均剂量，当体积参数不等于n = 1时，LKB模型拟合无明显改善。接受激素治疗的患者的毒性发生率显着降低（P = 0.024）。结论：平均剂量分数的变化解释了急性直肠毒性的发生率的差异，此处未发现所递送的剂量分数数量上的差异。

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