Department of Radiation Oncology, University of Colorado-Denver School of Medicine, Aurora, CO 80045, USA.
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S101-7. doi: 10.1016/j.ijrobp.2009.05.071.
Published data suggest that the risk of moderately severe (>or=Grade 3) radiation-induced acute small-bowel toxicity can be predicted with a threshold model whereby for a given dose level, D, if the volume receiving that dose or greater (VD) exceeds a threshold quantity, the risk of toxicity escalates. Estimates of VD depend on the means of structure segmenting (e.g., V15 = 120 cc if individual bowel loops are outlined or V45 = 195 cc if entire peritoneal potential space of bowel is outlined). A similar predictive model of acute toxicity is not available for stomach. Late small-bowel/stomach toxicity is likely related to maximum dose and/or volume threshold parameters qualitatively similar to those related to acute toxicity risk. Concurrent chemotherapy has been associated with a higher risk of acute toxicity, and a history of abdominal surgery has been associated with a higher risk of late toxicity.
已发表的数据表明，中重度（>=3 级）放射性急性小肠毒性的风险可以通过阈值模型进行预测，根据该模型，对于给定的剂量水平 D，如果接受该剂量或更高剂量的体积（VD）超过阈值量，则毒性风险会增加。VD 的估计取决于结构分段的方法（例如，如果单独勾画肠袢，则 V15=120cc，如果勾画整个腹膜腔肠，则 V45=195cc）。对于胃，目前还没有类似的急性毒性预测模型。迟发性小肠/胃毒性可能与最大剂量和/或体积阈值参数有关，这些参数与急性毒性风险的参数相似。同期化疗与急性毒性风险增加相关，腹部手术史与迟发性毒性风险增加相关。
