放疗后腮腺功能：密歇根大学和乌得勒支大学的联合经验。
Parotid gland function after radiotherapy: the combined michigan and utrecht experience.
机构信息
Department of Radiotherapy, University Medical Center Utrecht, The Netherlands.
出版信息
Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):449-53. doi: 10.1016/j.ijrobp.2009.07.1708. Epub 2010 Jan 7.
PURPOSE
To analyze the combined and updated results from the University of Michigan and University Medical Center Utrecht on normal tissue complication probability (NTCP) of the parotid gland 1 year after radiotherapy (RT) for head-and-neck (HN) cancer.
PATIENTS AND METHODS
A total of 222 prospectively analyzed patients with various HN malignancies were treated with conventional and intensity-modulated RT. Stimulated individual parotid gland flow rates were measured before RT and 1 year after RT using Lashley cups at both centers. A flow ratio <25% of pretreatment was defined as a complication. The data were fitted to the Lyman-Kutcher-Burman model.
RESULTS
A total of 384 parotid glands (Michigan: 157; Utrecht: 227 glands) was available for analysis 1 year after RT. Combined NTCP analysis based on mean dose resulted in a TD(50) (uniform dose leading to 50% complication probability) of 39.9 Gy and m (steepness of the curve) of 0.40. The resulting NTCP curve had good qualitative agreement with the combined clinical data. Mean doses of 25-30 Gy were associated with 17-26% NTCP.
CONCLUSIONS
A definite NTCP curve for parotid gland function 1 year after RT is presented, based on mean dose. No threshold dose was observed, and TD(50) was equal to 40 Gy.
目的
分析密歇根大学和乌得勒支大学医学中心关于头颈部癌症放疗后 1 年腮腺正常组织并发症概率（NTCP）的联合更新结果。
方法
共分析了 222 例接受常规和调强放疗的各种头颈部恶性肿瘤患者。在两个中心，使用 Lashley 杯在放疗前和放疗后 1 年测量个体腮腺流量率。将预处理时流量比<25%定义为并发症。将数据拟合到 Lyman-Kutcher-Burman 模型中。
结果
共有 384 个腮腺（密歇根：157 个；乌得勒支：227 个）在放疗后 1 年可用于分析。基于平均剂量的联合 NTCP 分析得出 TD(50)（导致 50%并发症概率的均匀剂量）为 39.9 Gy 和 m（曲线的陡峭度）为 0.40。所得 NTCP 曲线与联合临床数据具有良好的定性一致性。25-30 Gy 的平均剂量与 17-26%的 NTCP 相关。
结论
根据平均剂量，提出了放疗后 1 年腮腺功能的明确 NTCP 曲线。未观察到阈值剂量，TD(50)等于 40 Gy。
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