Royal Marsden Hospital, Sutton, Surrey, UK.
Radiother Oncol. 2012 Apr;103(1):88-91. doi: 10.1016/j.radonc.2011.12.027. Epub 2012 Jan 24.
Dose-response curves (DRCs) and the quantitative parameters describing these curves were generated for grade 3 oral mucositis and dysphagia in 144 patients using individual patient DVHs. Curve fits to the oral mucositis clinical data yielded parameter values of mean dose in 2 Gy equivalent, MD(50) = 51 Gy (95% CI 40-61), slope of the curve, k = 1(95% CI 0.6-1.5). R(2) value for the goodness of fit was 0.80. Fits to the grade 3 dysphagia clinical data yielded parameter values of MD(50) = 44.5 Gy (95% CI 36-53), k = 2.6 (95% CI 0.8-4.5). R(2) value for the goodness of fit was 0.65. This is the first study to derive DRCs in patients receiving induction chemotherapy followed by chemo-radiation (IC-C-IMRT) for head and neck cancer. The dose-response model described in this study could be useful for comparing acute mucositis rates for different dose-fractionation schedules when using IMRT for head and neck cancer.
为 144 名患者使用个体患者剂量体积直方图生成了用于 3 级口腔黏膜炎和吞咽困难的剂量反应曲线 (DRC) 和描述这些曲线的定量参数。对口腔黏膜炎临床数据进行曲线拟合，得出了平均剂量为 2Gy 等效值的参数值，MD(50)=51Gy(95%CI40-61)，曲线斜率 k=1(95%CI0.6-1.5)。拟合优度的 R(2)值为 0.80。对 3 级吞咽困难临床数据的拟合得出了 MD(50)=44.5Gy(95%CI36-53)，k=2.6(95%CI0.8-4.5)的参数值。拟合优度的 R(2)值为 0.65。这是第一份在接受诱导化疗后接受化疗-放疗（IC-C-IMRT）治疗头颈部癌症的患者中得出 DRC 的研究。本研究中描述的剂量反应模型可用于比较使用 IMRT 治疗头颈部癌症时不同剂量分割方案的急性黏膜炎发生率。
