Roers Julian, Rolf Daniel, Baehr Andrea, Pöttgen Christoph, Stickan-Verfürth Martina, Siats Jan, Hering Dominik A, Moustakis Christos, Grohmann Maximilian, Oertel Michael, Haverkamp Uwe, Stuschke Martin, Timmermann Beate, Eich Hans T, Reinartz Gabriele
Department of Radiation Oncology, University Hospital of Münster, West German Cancer Center (WTZ) Network Partner Site, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.
Department of Radiation Oncology, University Hospital of Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Cancers (Basel). 2023 Dec 5;15(24):5712. doi: 10.3390/cancers15245712.
This biophysical study aimed to determine fitting parameters for the Lyman-Kutcher-Burman (LKB) dose-response model for normal tissue complication probability (NTCP) calculations of acute side effects and to investigate the impact of reduced radiation doses on the probability of their occurrence in supradiaphragmatic non-Hodgkin lymphoma (NHL) irradiation. A cohort of 114 patients with NHL in the cervicothoracic region, treated between 2015 and 2021 at the University Hospitals of Münster, Hamburg, and Essen, with involved site radiation therapy (ISRT), were included. Among them, 68 patients with aggressive NHL (a-NHL) received consolidative radiation therapy with 24-54 Gy following (R-)CHOP chemotherapy. Additionally, 46 patients with indolent NHL (i-NHL) underwent radiotherapy with 22.5-45.0 Gy. Two treatment plans were prospectively created for each patient (a-NHL: 30.0/40.0 Gy; i-NHL: 24.0/30.0 Gy). NTCP were then calculated using the optimized LKB model. The adapted dose-response models properly predicted the patient's probability of developing acute side effects when receiving doses ≤ 50 Gy. In addition, it was shown that reduced radiation doses can influence the NTCP of acute side effects depending on the aggressiveness of NHL significantly. This study provided a foundation to prospectively assess the probability of adverse side effects among today's reduced radiation doses in the treatment of NHL.
这项生物物理学研究旨在确定用于计算急性副作用的正常组织并发症概率（NTCP）的莱曼 - 库彻 - 伯曼（LKB）剂量反应模型的拟合参数，并研究降低辐射剂量对膈上非霍奇金淋巴瘤（NHL）放疗中急性副作用发生概率的影响。纳入了2015年至2021年期间在明斯特、汉堡和埃森大学医院接受受累部位放射治疗（ISRT）的114例颈胸段NHL患者队列。其中，68例侵袭性NHL（a - NHL）患者在（R -）CHOP化疗后接受了24 - 54 Gy的巩固性放射治疗。此外，46例惰性NHL（i - NHL）患者接受了22.5 - 45.0 Gy的放射治疗。为每位患者前瞻性地制定了两个治疗计划（a - NHL：30.0/40.0 Gy；i - NHL：24.0/30.0 Gy）。然后使用优化的LKB模型计算NTCP。调整后的剂量反应模型能够准确预测患者在接受≤50 Gy剂量时发生急性副作用的概率。此外，研究表明，降低辐射剂量会根据NHL的侵袭性显著影响急性副作用的NTCP。本研究为前瞻性评估当今NHL治疗中降低辐射剂量时不良副作用的发生概率提供了基础。
