Cao Ying, Tang Du, Xiang Yining, Men Li, Liu Chao, Zhou Qin, Wu Jun, Huo Lei, Song Tao, Wang Ying, Li Zhanzhan, Wei Rui, Shen Liangfang, Yang Zhen, Hong Jidong
Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Cancer Manag Res. 2021 Apr 28;13:3561-3572. doi: 10.2147/CMAR.S300094. eCollection 2021.
To investigate the appropriate timing of adaptive radiotherapy (ART) for high-grade glioma.
Ten patients with high-grade gliomas were selected and underwent CT/MRI (CT/MRI, CT/MRI, CT/MRI, and CT/MRI) scans before RT and during 10-, 20- and 30-fraction RT, and the corresponding RT plans (plan, plan, plan and plan) were made. The dose of the initial plan (plan) was projected to CT2 and CT3 using the image registration technique to obtain the projection plans (plan and plan) and by superimposing the doses to obtain the ART plans (plan and plan), respectively. The dosimetric differences in the target volume and organs at risk (OARs) were compared between the projection and adaptive plans. The tumor control probability (TCP) for the planning target volume (PTV) and normal tissue complication probability (NTCP) for the OARs were compared between the two adaptive plans.
Compared with the projection plan, the D to the PTV of ART decreased, the conformity index (CI) to the PTV increased, and the D/D to the brainstem, optic chiasm and pituitary, as well as the V, V, V and V to the normal brain decreased. The D to the pituitary and optic chiasm as well as the V, V, V and V to the normal brain in plan were lower than those in plan, while the CI to the PTV was higher than that in plan. The TCP of the PTV in plan was higher than that in plan.
ART can improve the precision of target volume irradiation and reduce the irradiation dose to the OARs in high-grade glioma. The time point after 10 fractions of RT is appropriate for ART.
探讨高级别胶质瘤自适应放疗（ART）的合适时机。
选取10例高级别胶质瘤患者，在放疗前及放疗第10、20和30分次时进行CT/MRI（CT/MRI、CT/MRI、CT/MRI和CT/MRI）扫描，并制定相应的放疗计划（计划、计划、计划和计划）。利用图像配准技术将初始计划（计划）的剂量投射到CT2和CT3上，分别获得投射计划（计划和计划），并通过剂量叠加获得ART计划（计划和计划）。比较投射计划和自适应计划在靶区体积和危及器官（OARs）方面的剂量学差异。比较两个自适应计划在计划靶区（PTV）的肿瘤控制概率（TCP）和OARs的正常组织并发症概率（NTCP）。
与投射计划相比，ART的PTV的D降低，PTV的适形指数（CI）增加，脑干、视交叉和垂体的D/D以及正常脑的V、V、V和V降低。计划中垂体和视交叉的D以及正常脑的V、V、V和V低于计划，而PTV的CI高于计划。计划中PTV的TCP高于计划。
ART可提高高级别胶质瘤靶区照射的精度，降低对OARs的照射剂量。放疗10分次后的时间点适合进行ART。
