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碳离子放射治疗中基于微剂量动力学模型和局部效应模型的靶区和危及器官的 RBE 加权剂量转换在前列腺癌中的应用。

RBE-weighted dose conversions for carbon ionradiotherapy between microdosimetric kinetic model and local effect model for the targets and organs at risk in prostate carcinoma.

机构信息

Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, China.

Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, China; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, China.

出版信息

Radiother Oncol. 2020 Mar;144:30-36. doi: 10.1016/j.radonc.2019.10.005. Epub 2019 Nov 8.

Abstract

BACKGROUND AND PURPOSE

The aim of this study was to establish curves for the conversion of RBE-weighted doses for targets and organs at risk (OARs) from the microdosimetric kinetic model (MKM) calculation to that of the local effect model I (LEM) for carbon ion radiotherapy (CIRT) for prostate carcinoma (PCA).

MATERIALS AND METHODS

This study was performed in the experimental treatment planning system (eTPS, V8A, Raystation, Sweden), which incorporates both MKM and LEM. CIRT plans from 10 PCA patients were collected. There were 5 steps to establish the curves: (1) design MKM plans in eTPS; (2) recalculate the physical doses from MKM to LEM and create a LEM plan in eTPS; (3) plot the RBE-weighted MKM to LEM conversion curves; (4) convert the MKM rectum constraint dose volume histogram (DVH) from NIRS to a LEM DVH; and (5) compare patients' rectum DVHs and follow-up with the converted constraint DVH.

RESULTS

The conversion factors for MKM doses of 0.18 Gy (RBE) to 4.55 Gy (RBE) per fraction to LEM doses were 2.72-1.06. For fraction sizes of >1 Gy (RBE), the conversion factors matched Fossati's curve and for fraction sizes of <1.00 Gy (RBE) the values were on the extrapolated Fossati's curve. A LEM rectum constraint DVH was established. Ten patients' rectum DVHs were all lower than LEM constraint DVHs. No complications were reported clinically.

CONCLUSION

For PCA receiving CIRT, the RBE-weighted doses using MKM for targets and OARs could be converted to LEM doses using conversion curves.

摘要

背景与目的

本研究旨在为前列腺癌碳离子放射治疗(CIRT)建立从微剂量动力学模型(MKM)计算到局部效应模型 I(LEM)转换靶区和危及器官(OARs)RBE 加权剂量的曲线。

材料与方法

本研究在包含 MKM 和 LEM 的实验治疗计划系统(eTPS,V8A,Raystation,瑞典)中进行。收集了 10 例前列腺癌患者的 CIRT 计划。建立曲线有 5 个步骤:(1)在 eTPS 中设计 MKM 计划;(2)从 MKM 重新计算物理剂量并在 eTPS 中创建 LEM 计划;(3)绘制 RBE 加权 MKM 到 LEM 转换曲线;(4)将 MKM 直肠约束剂量体积直方图(DVH)从 NIRS 转换为 LEM DVH;(5)比较患者的直肠 DVH 和随访与转换后的约束 DVH。

结果

0.18 Gy(RBE)至 4.55 Gy(RBE)/分次的 MKM 剂量转换为 LEM 剂量的转换因子为 2.72-1.06。对于大于 1 Gy(RBE)的分次剂量,转换因子与 Fossati 曲线匹配,对于小于 1.00 Gy(RBE)的分次剂量,值位于外推 Fossati 曲线上。建立了 LEM 直肠约束 DVH。10 例患者的直肠 DVH 均低于 LEM 约束 DVH。临床未报告并发症。

结论

对于接受 CIRT 的前列腺癌,使用 MKM 对靶区和 OARs 进行的 RBE 加权剂量可以使用转换曲线转换为 LEM 剂量。

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