中晚期食管癌心脏和脊髓形态学参数与剂量学参数的相关性。

Correlation between morphological parameters and dosimetric parameters of the heart and spinal cord in the intermediate- and advanced-stage esophageal cancer.

机构信息

School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China.

Department of Radiation Therapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

出版信息

Cancer Rep (Hoboken). 2024 Mar;7(3):e2015. doi: 10.1002/cnr2.2015.

DOI:10.1002/cnr2.2015

PMID:38488482

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10941519/

Abstract

BACKGROUND

Radiation therapy plays a pivotal role as the primary adjuvant treatment for esophageal cancer (EPC), emphasizing the critical importance of carefully balancing radiation doses to the target area and organs at risk in the radiotherapeutic management of esophageal cancer.

AIMS

This study aimed to explore the correlation between morphological parameters and dosimetric parameters of the heart and spinal cord in intermediate- and advanced-stage esophagus cancer to provide a reference for clinical treatment.

METHODS AND RESULTS

A total of 105 patients with intermediate- and advanced-stage EPC, who received treatment in our hospital from 2019 to 2021, were included. The morphological parameters were calculated by imaging. Intensity-modulated radiation therapy plan was executed at Raystation4.7. The PTV-G stood for the externally expanded planning target volume (PTV) of the gross tumor volume (GTV) and PTV-C for the externally expanded volume of the clinical target volume (CTV). The prescription dose of PTV-G and PTV-C was set as 60Gy/30F and 54Gy/30F, respectively. The linear regression model was used to analyze the correlation between morphologic parameters of EPC and dosimetric parameters of the heart and spinal cord. In 105 cases, the total lung length was correlated with the spinal cord maximum dose (D ). The heart mean doses (D ) and heart V (the relative volume that receives 40 Gy or more) was correlated with PTV-G volume, PTV-G length; In middle- and upper-segment EPC cases, only the total lung volume was correlated with the spinal cord D , spinal cord D , heart D , and heart V ; In middle-stage EPC cases, the heart D was correlated with the PTV-G volume, PTV-G length. The total lung length was correlated with the spinal cord D ; In middle- and lower-segment EPC, only the PTV-G volume and PTV-G length were correlated with the heart D . All the aforementioned values were statistically significant.

CONCLUSIONS

Combined with the unsegmented tumor and different locations, the organ at risk dose was comprehensively considered.

摘要

背景

放射治疗在食管癌（EPC）的主要辅助治疗中起着关键作用，强调在食管癌的放射治疗管理中，仔细平衡靶区和危险器官的放射剂量至关重要。

目的

本研究旨在探讨中晚期食管癌心脏和脊髓的形态学参数与剂量学参数之间的相关性，为临床治疗提供参考。

方法和结果

共纳入我院 2019 年至 2021 年治疗的 105 例中晚期 EPC 患者。通过影像学计算形态学参数。在 Raystation4.7 上执行调强放射治疗计划。PTV-G 代表大体肿瘤体积（GTV）的外部扩展计划靶区（PTV），PTV-C 代表临床靶区（CTV）的外部扩展体积。PTV-G 和 PTV-C 的处方剂量分别设定为 60Gy/30F 和 54Gy/30F。使用线性回归模型分析 EPC 的形态学参数与心脏和脊髓的剂量学参数之间的相关性。在 105 例中，总肺长度与脊髓最大剂量（D ）相关。心脏平均剂量（D ）和心脏 V（接受 40Gy 或更高剂量的相对体积）与 PTV-G 体积、PTV-G 长度相关；在中上部 EPC 病例中，仅总肺体积与脊髓 D 、脊髓 D 、心脏 D 、心脏 V 相关；在中 EPC 病例中，心脏 D 与 PTV-G 体积、PTV-G 长度相关。总肺长度与脊髓 D 相关；在中下部 EPC 中，仅 PTV-G 体积和 PTV-G 长度与心脏 D 相关。所有这些值均具有统计学意义。