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患者特定参数与个体化乳腺癌放射治疗剂量学指标的相关性。

Correlations between patient-specific parameters and dosimetric indices for personalized breast cancer radiotherapy.

机构信息

Faculty of Physics, West University of Timisoara, 300223, Timisoara, Romania.

Bihor County Emergency Clinical Hospital, 410167, Oradea, Romania.

出版信息

Sci Rep. 2024 Oct 30;14(1):26141. doi: 10.1038/s41598-024-75858-4.

Abstract

Treatment planning parameters in radiotherapy are key elements that dictate the success of treatment outcome. While some parameters are commonly evaluated irrespective of cancer type, others are site-dependent and strongly patient specific. Given the critical influence of planning parameters on personalized therapy, the aim of this study was to evaluate the correlations between the dosimetric indices (conformity, homogeneity and mismatch indices) related to tumor coverage and the patient-specific parameters which encompass parameters pertaining to organs at risk (widths and lengths of heart and ipsilateral lung included in treatment fields, mean/maximum doses to heart, ipsilateral lung, left anterior descending aorta and contralateral breast) and tumor volume. Forty breast cancer patients were divided into two groups according to tumor location: twenty with left-sided (group A) and twenty with right-sided breast cancer (group B). Conformal (3DCRT), intensity modulated (IMRT) and volumetric arc modulated (VMAT) radiotherapy techniques were used for plan creation. Moderate to strong correlations were found for ipsilateral lung parameters for both groups of patients regardless of the treatment technique. Moderate to strong correlations were found for heart parameters in group A patients, while no correlations were observed in group B. The mismatch index presented moderate to strong correlations with tumor volume for all treatment techniques (r = -0.861 3DCRT, r = -0.556 IMRT, r = -0.533 VMAT) particularly in group A. The evaluated correlations indicate the role of dosimetric indices in personalized treatment planning.

摘要

放射治疗中的治疗计划参数是决定治疗效果的关键因素。虽然有些参数无论癌症类型如何都通常进行评估,但其他参数则取决于部位,并且与患者个体高度相关。鉴于计划参数对个性化治疗的重要影响,本研究旨在评估与肿瘤覆盖相关的剂量学指标(适形度、均匀度和不匹配指数)与患者特异性参数(包括危及器官参数和肿瘤体积参数)之间的相关性。

将 40 名乳腺癌患者根据肿瘤位置分为两组:20 名左侧乳腺癌患者(A 组)和 20 名右侧乳腺癌患者(B 组)。采用三维适形放疗(3DCRT)、调强放疗(IMRT)和容积旋转调强放疗(VMAT)技术进行计划制定。

无论治疗技术如何,两组患者的同侧肺参数均显示出中度至强相关性。A 组患者的心脏参数也显示出中度至强相关性,而 B 组患者则无相关性。对于所有治疗技术,不匹配指数与肿瘤体积之间均显示出中度至强相关性(r = -0.861 3DCRT、r = -0.556 IMRT、r = -0.533 VMAT),特别是在 A 组中。

评估的相关性表明剂量学指标在个性化治疗计划中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23fa/11526019/1232d7d6e892/41598_2024_75858_Fig1_HTML.jpg

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