¹¹C-胆碱正电子发射断层扫描在局限性前列腺癌调强放疗中的剂量描绘。
Intensity modulated radiation therapy dose painting for localized prostate cancer using ¹¹C-choline positron emission tomography scans.
机构信息
Radiation Oncology Centre, Austin Health, Victoria, Australia.
出版信息
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e691-6. doi: 10.1016/j.ijrobp.2012.01.087. Epub 2012 May 30.
PURPOSE
To demonstrate the technical feasibility of intensity modulated radiation therapy (IMRT) dose painting using (11)C-choline positron emission tomography PET scans in patients with localized prostate cancer.
METHODS AND MATERIALS
This was an RT planning study of 8 patients with prostate cancer who had (11)C-choline PET scans prior to radical prostatectomy. Two contours were semiautomatically generated on the basis of the PET scans for each patient: 60% and 70% of the maximum standardized uptake values (SUV(60%) and SUV(70%)). Three IMRT plans were generated for each patient: PLAN(78), which consisted of whole-prostate radiation therapy to 78 Gy; PLAN(78-90), which consisted of whole-prostate RT to 78 Gy, a boost to the SUV(60%) to 84 Gy, and a further boost to the SUV(70%) to 90 Gy; and PLAN(72-90), which consisted of whole-prostate RT to 72 Gy, a boost to the SUV(60%) to 84 Gy, and a further boost to the SUV(70%) to 90 Gy. The feasibility of these plans was judged by their ability to reach prescription doses while adhering to published dose constraints. Tumor control probabilities based on PET scan-defined volumes (TCP(PET)) and on prostatectomy-defined volumes (TCP(path)), and rectal normal tissue complication probabilities (NTCP) were compared between the plans.
RESULTS
All plans for all patients reached prescription doses while adhering to dose constraints. TCP(PET) values for PLAN(78), PLAN(78-90), and PLAN(72-90) were 65%, 97%, and 96%, respectively. TCP(path) values were 71%, 97%, and 89%, respectively. Both PLAN(78-90) and PLAN(72-90) had significantly higher TCP(PET) (P=.002 and .001) and TCP(path) (P<.001 and .014) values than PLAN(78). PLAN(78-90) and PLAN(72-90) were not significantly different in terms of TCP(PET) or TCP(path). There were no significant differences in rectal NTCPs between the 3 plans.
CONCLUSIONS
IMRT dose painting for localized prostate cancer using (11)C-choline PET scans is technically feasible. Dose painting results in higher TCPs without higher NTCPs.
目的
展示使用（11）C-胆碱正电子发射断层扫描（PET）在局限性前列腺癌患者中进行调强放疗（IMRT）剂量绘画的技术可行性。
方法与材料
这是一项针对 8 例前列腺癌患者的 RT 计划研究，这些患者在根治性前列腺切除术前进行了（11）C-胆碱 PET 扫描。基于每位患者的 PET 扫描，半自动生成了两个轮廓：最大标准化摄取值（SUV（60%）和 SUV（70%）的 60%和 70%。为每位患者生成了 3 个 IMRT 计划：PLAN（78），包括前列腺 78 Gy 的全野放疗；PLAN（78-90），包括前列腺 78 Gy 的全野放疗、SUV（60%）的 84 Gy 推量放疗和 SUV（70%）的 90 Gy 推量放疗；PLAN（72-90），包括前列腺 72 Gy 的全野放疗、SUV（60%）的 84 Gy 推量放疗和 SUV（70%）的 90 Gy 推量放疗。通过遵守已发表的剂量限制来判断这些计划的可行性。根据 PET 扫描定义的体积（TCP（PET））和前列腺切除术定义的体积（TCP（path））比较了这些计划的肿瘤控制概率，以及直肠正常组织并发症概率（NTCP）。
结果
所有患者的所有计划均达到处方剂量，同时遵守剂量限制。PLAN（78）、PLAN（78-90）和 PLAN（72-90）的 TCP（PET）值分别为 65%、97%和 96%。TCP（path）值分别为 71%、97%和 89%。PLAN（78-90）和 PLAN（72-90）的 TCP（PET）（P=.002 和.001）和 TCP（path）（P<.001 和.014）值均显著高于 PLAN（78）。PLAN（78-90）和 PLAN（72-90）在 TCP（PET）或 TCP（path）方面没有显著差异。3 种方案之间的直肠 NTCP 无显著差异。
结论
使用（11）C-胆碱 PET 扫描进行局限性前列腺癌的调强放疗剂量绘画在技术上是可行的。剂量绘画可提高 TCP，而不会增加 NTCP。
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