Department of Oncology-Pathology, Division of Medical Radiation Physics, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Radiother Oncol. 2010 Oct;97(1):54-9. doi: 10.1016/j.radonc.2010.04.021. Epub 2010 May 31.
Determination of the dose-response relations for oesophageal stricture after radiotherapy of the head and neck.
In this study 33 patients who developed oesophageal stricture and 39 patients as controls are included. The patients received radiation therapy for head and neck cancer at Karolinska University Hospital, Stockholm, Sweden. For each patient the 3D dose distribution delivered to the upper 5 cm of the oesophagus was analysed. The analysis was conducted for two periods, 1992-2000 and 2001-2005, due to the different irradiation techniques used. The fitting has been done using the relative seriality model.
For the treatment period 1992-2005, the mean doses were 49.8 and 33.4 Gy, respectively, for the cases and the controls. For the period 1992-2000, the mean doses for the cases and the controls were 49.9 and 45.9 Gy and for the period 2001-2005 were 49.8 and 21.4 Gy. For the period 2001-2005 the best estimates of the dose-response parameters are D(50)=61.5 Gy (52.9-84.9 Gy), γ=1.4 (0.8-2.6) and s=0.1 (0.01-0.3).
Radiation-induced strictures were found to have a dose response relation and volume dependence (low relative seriality) for the treatment period 2001-2005. However, no dose response relation was found for the complete material.
确定头颈部放疗后食管狭窄的剂量-反应关系。
本研究纳入了 33 例发生食管狭窄的患者和 39 例对照患者。这些患者在瑞典斯德哥尔摩卡罗林斯卡大学医院接受了头颈部癌症的放射治疗。对每位患者的食管上段 5cm 所接受的 3D 剂量分布进行了分析。由于使用了不同的照射技术，分析分为两个时期，1992-2000 年和 2001-2005 年。拟合采用相对串行性模型进行。
在 1992-2005 年的治疗期间，病例组和对照组的平均剂量分别为 49.8Gy 和 33.4Gy。在 1992-2000 年期间，病例组和对照组的平均剂量分别为 49.9Gy 和 45.9Gy，而在 2001-2005 年期间，病例组和对照组的平均剂量分别为 49.8Gy 和 21.4Gy。在 2001-2005 年期间，剂量-反应参数的最佳估计值为 D(50)=61.5Gy（52.9-84.9Gy），γ=1.4（0.8-2.6）和 s=0.1（0.01-0.3）。
在 2001-2005 年的治疗期间，发现放射性狭窄与剂量存在相关性，且与体积相关（低相对串行性）。然而，对于完整的材料，并未发现剂量反应关系。
