Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S123-9. doi: 10.1016/j.ijrobp.2009.03.078.
The available dose/volume/outcome data for rectal injury were reviewed. The volume of rectum receiving >or=60 Gy is consistently associated with the risk of Grade >or=2 rectal toxicity or rectal bleeding. Parameters for the Lyman-Kutcher-Burman normal tissue complication probability model from four clinical series are remarkably consistent, suggesting that high doses are predominant in determining the risk of toxicity. The best overall estimates (95% confidence interval) of the Lyman-Kutcher-Burman model parameters are n = 0.09 (0.04-0.14); m = 0.13 (0.10-0.17); and TD(50) = 76.9 (73.7-80.1) Gy. Most of the models of late radiation toxicity come from three-dimensional conformal radiotherapy dose-escalation studies of early-stage prostate cancer. It is possible that intensity-modulated radiotherapy or proton beam dose distributions require modification of these models because of the inherent differences in low and intermediate dose distributions.
对直肠损伤的可用剂量/体积/结果数据进行了回顾。直肠接受>或=60 Gy 的体积与 2 级或更高级别的直肠毒性或直肠出血风险始终相关。来自四个临床系列的 Lyman-Kutcher-Burman 正常组织并发症概率模型的参数非常一致，表明高剂量是决定毒性风险的主要因素。Lyman-Kutcher-Burman 模型参数的最佳总体估计值（95%置信区间）为 n = 0.09（0.04-0.14）；m = 0.13（0.10-0.17）；TD(50)=76.9（73.7-80.1）Gy。大多数晚期放射毒性模型来自早期前列腺癌的三维适形放疗剂量递增研究。由于低剂量和中剂量分布的固有差异，调强放疗或质子束剂量分布可能需要对这些模型进行修改。
