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使用队列剂量体积直方图数据对十二指肠放射治疗毒性进行建模。

Modelling duodenum radiotherapy toxicity using cohort dose-volume-histogram data.

作者信息

Holyoake Daniel L P, Aznar Marianne, Mukherjee Somnath, Partridge Mike, Hawkins Maria A

机构信息

CRUK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, United Kingdom.

Nuffield Department of Population Health, University of Oxford, United Kingdom.

出版信息

Radiother Oncol. 2017 Jun;123(3):431-437. doi: 10.1016/j.radonc.2017.04.024. Epub 2017 Jun 6.

DOI:10.1016/j.radonc.2017.04.024
PMID:28600084
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5486774/
Abstract

BACKGROUND AND PURPOSE

Gastro-intestinal toxicity is dose-limiting in abdominal radiotherapy and correlated with duodenum dose-volume parameters. We aimed to derive updated NTCP model parameters using published data and prospective radiotherapy quality-assured cohort data.

MATERIAL AND METHODS

A systematic search identified publications providing duodenum dose-volume histogram (DVH) statistics for clinical studies of conventionally-fractionated radiotherapy. Values for the Lyman-Kutcher-Burman (LKB) NTCP model were derived through sum-squared-error minimisation and using leave-one-out cross-validation. Data were corrected for fraction size and weighted according to patient numbers, and the model refined using individual patient DVH data for two further cohorts from prospective clinical trials.

RESULTS

Six studies with published DVH data were utilised, and with individual patient data included outcomes for 531 patients in total (median follow-up 16months). Observed gastro-intestinal toxicity rates ranged from 0% to 14% (median 8%). LKB parameter values for unconstrained fit to published data were: n=0.070, m=0.46, TD [Gy]=183.8, while the values for the model incorporating the individual patient data were n=0.193, m=0.51, TD [Gy]=299.1.

CONCLUSIONS

LKB parameters derived using published data are shown to be consistent to those previously obtained using individual patient data, supporting a small volume-effect and dependence on exposure to high threshold dose.

摘要

背景与目的

胃肠道毒性是腹部放疗的剂量限制因素，且与十二指肠剂量 - 体积参数相关。我们旨在利用已发表的数据和前瞻性放疗质量保证队列数据推导出更新的正常组织并发症概率（NTCP）模型参数。

材料与方法

通过系统检索，确定了提供常规分割放疗临床研究中十二指肠剂量 - 体积直方图（DVH）统计数据的出版物。通过最小化误差平方和并使用留一法交叉验证得出莱曼 - 库彻 - 伯曼（LKB）NTCP模型的值。对分次剂量数据进行校正，并根据患者数量加权，然后使用来自前瞻性临床试验的另外两个队列的个体患者DVH数据对模型进行优化。

结果

利用了六项有已发表DVH数据的研究，纳入个体患者数据后，总共531例患者（中位随访时间16个月）有了结果。观察到的胃肠道毒性发生率在0%至14%之间（中位值8%）。对已发表数据进行无约束拟合的LKB参数值为：n = 0.070，m = 0.46，TD [Gy] = 183.8，而纳入个体患者数据的模型参数值为n = 0.193，m = 0.51，TD [Gy] = 299.1。

结论

使用已发表数据得出的LKB参数与先前使用个体患者数据获得的参数一致，支持小体积效应以及对高阈值剂量暴露的依赖性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/963f667a17cc/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/c03c71d8cfee/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/4ee4c5559caf/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/963f667a17cc/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/c03c71d8cfee/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/4ee4c5559caf/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/090e/5486774/963f667a17cc/gr3.jpg

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