勾画“口咽黏膜”并在头颈部癌症患者中限制其剂量可保护口咽而不影响靶区覆盖。

Delineation of the "Oropharyngeal Mucosa" and Limiting its Dose in Head and Neck Cancer Patients Spares the Oropharynx Without Compromising Target Coverage.

机构信息

Department of Radiotherapy, Hebei Province Hospital of Chinese Medicine, Shijiazhuang, China.

Department of Radiology, Hebei Province Hospital of Chinese Medicine, Shijiazhuang, China.

出版信息

Cancer Control. 2024 Jan-Dec;31:10732748241283621. doi: 10.1177/10732748241283621.

DOI:10.1177/10732748241283621

PMID:39275798

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11401141/

Abstract

OBJECTIVES

Radiation-induced oropharyngeal injury is a dose-limiting toxicity in head and neck cancer patients. Delineation of the "oropharyngeal mucosa" and limiting its dose to spare the oropharynx was investigated.

METHODS

In this retrospective study, computed tomography imaging from eight patients with previously untreated head and neck cancer was employed. An adaptive contouring brush within the planning software Monaco was used to create an air cavity within the oropharynx, and then the air cavity was expanded uniformly 2 mm to create the "oropharyngeal mucosa". Three plans were independently generated for each patient: Plan1: dose constraint was applied for the oropharynx; Plan2: dose constraints were applied for the oropharynx and the "oropharyngeal mucosa"; Plan3: dose constraint was applied for the "oropharyngeal mucosa". were used to compare the dosimetry variables.

RESULTS

All plans had adequate target coverage and there were no statistical differences among plans. The mean dose, D30%, D45%, D50%, D85%, D90%, D95%, D100%, V25 Gy, V30 Gy, V35 Gy, V40 Gy, and V45 Gy of the oropharynx and "oropharyngeal mucosa" in Plan1 were significantly higher than those in Plan2 and Plan3. There were no significant differences between Plan2 and Plan3. There were no significant differences in the dosimetric parameters of any other organs at risk.

CONCLUSION

Delineation of the "oropharyngeal mucosa" and limiting its dose should be an easy and effective method to spare the oropharynx.

摘要

目的

放射性口咽损伤是头颈部癌症患者的剂量限制毒性。本研究旨在对“口咽黏膜”进行勾画并限制其剂量以保护口咽。

方法

本回顾性研究共纳入 8 例未经治疗的头颈部癌症患者，使用 Monaco 计划系统中的自适应勾画刷在口咽内创建一个空腔，然后将空腔均匀扩张 2mm 以创建“口咽黏膜”。每位患者独立生成 3 个计划：计划 1：对口咽进行剂量限制；计划 2：对口咽和“口咽黏膜”进行剂量限制；计划 3：对口咽黏膜进行剂量限制。使用剂量学参数来比较不同计划。

结果

所有计划均能满足靶区覆盖要求，且组间无统计学差异。计划 1 的口咽和“口咽黏膜”的平均剂量（Dmean）、D30%、D45%、D50%、D85%、D90%、D95%、D100%、V25Gy、V30Gy、V35Gy、V40Gy 和 V45Gy 显著高于计划 2 和计划 3，而计划 2 和计划 3 之间无显著差异。任何其他危及器官的剂量学参数均无显著差异。