Li Fei, Shi Dan, Bu Mingwei, Lu Shuangchen, Zhao Hongfu
Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Radiation Oncology, Guowen Medical Corporation Changchun Hospital, Changchun, China.
Front Oncol. 2022 Jul 4;12:870570. doi: 10.3389/fonc.2022.870570. eCollection 2022.
The ICRU/GEC-ESTRO released the ICRU Report No. 89, which introduced the concept of four-dimensional brachytherapy and ushered in a new era of brachytherapy for cervical cancer. The purpose of this study was to evaluate the local control and late toxicity of four-dimensional brachytherapy in cervical cancer through a systematic review and to reveal the dose-response relationship between the volumetric dose paraments and the local control rate a probit model.
We identified studies that reported the HR-CTV D90 and local control probabilities by searching the PubMed Database, the Web of Science Core Collection and the Cochrane Library Database through February 1st, 2022. Regression analyses were performed between the HR-CTV D90 and the local control probability using a probit model.
Nineteen studies enrolling 3,616 patients were included. The probit model showed a significant relationship between the HR-CTV D90 value and IR-CTV D90 Vs. the local control probability, P < 0.001 and P = 0.003, respectively. The D90 for HR-CTV and IR-CTV corresponding to a probability of 90% local control was 79.1 GyEQD2,10 (95% CI:69.8 - 83.7 GyEQD2,10) and 66.5 GyEQD2,10 (95% CI: 62.8 - 67.9 GyEQD2,10), respectively. The limits for the prescribed dose of 85 GyEQD2,10 for HR-CTV D90 theoretically warranted a 92.1% (95% CI: 90.2% - 95.3%) local control rate, and 87.2% (95% CI: 82.4% - 91.8%) local control probability was expected for 65 GyEQD2,10 to IR-CTV D90. The probit model showed no significant relationship between the D2cc to organs at risk and the probability of grade 3 and above gastrointestinal or genitourinary toxicity.
Four-dimensional brachytherapy takes into account uncertain factors such as tumour regression, internal organ motion and organ filling, and provides a more accurate and more therapeutic ratio delivery through adaptive delineation and replanning, replacement of the applicator, and the addition of interstitial needles. The dose volume effect relationship of four-dimensional brachytherapy between the HR-CTV D90 and the local control rate provides an objective planning aim dose.
国际辐射单位与测量委员会（ICRU）/欧洲妇科肿瘤协作组（GEC-ESTRO）发布了第89号ICRU报告，该报告引入了四维近距离放射治疗的概念，开创了宫颈癌近距离放射治疗的新时代。本研究的目的是通过系统评价评估四维近距离放射治疗在宫颈癌中的局部控制情况和晚期毒性，并通过概率单位模型揭示体积剂量参数与局部控制率之间的剂量反应关系。
通过检索PubMed数据库、科学引文索引核心合集（Web of Science Core Collection）和Cochrane图书馆数据库，我们确定了截至2022年2月1日报告高危临床靶体积（HR-CTV）D90和局部控制概率的研究。使用概率单位模型对HR-CTV D90与局部控制概率进行回归分析。
纳入了19项研究，共3616例患者。概率单位模型显示HR-CTV D90值与初始临床靶体积（IR-CTV）D90与局部控制概率之间存在显著关系，P值分别<0.001和P = 0.003。局部控制概率为90%时，HR-CTV和IR-CTV的D90分别为79.1 Gy等效剂量（EQD2，10）（95%可信区间：69.8 - 83.7 GyEQD2，10）和66.5 GyEQD2，10（95%可信区间：62.8 - 67.9 GyEQD2，10）。理论上，HR-CTV D90规定剂量为85 GyEQD2，10时，局部控制率为92.1%（95%可信区间：90.2% - 95.3%），IR-CTV D90为65 GyEQD2，10时，局部控制概率预计为87.2%（95%可信区间：82.4% - 91.8%）。概率单位模型显示，危及器官的D2cc与3级及以上胃肠道或泌尿生殖系统毒性概率之间无显著关系。
四维近距离放射治疗考虑了肿瘤退缩、内部器官运动和器官充盈等不确定因素，并通过自适应勾画和重新计划、更换施源器以及添加组织间插植针提供了更精确、治疗比更高的剂量给予。四维近距离放射治疗中HR-CTV D90与局部控制率之间的剂量体积效应关系提供了一个客观的计划目标剂量。
Zotero 插件
