Roth J, Hünig R, Hügli C
Abteilung für Radiologische Physik, Kantonsspital Basel.
Strahlenther Onkol. 1995 Mar;171(3):149-53.
The tissue tolerance of a small radiation dose to a large tissue volume applied in small fractions is expected to be different from the tolerance of a high dose to a small volume given in large fractions. Corresponding criteria for judgment have to be worked out.
Using the example of oesophagus carcinoma, dose-volume histograms for diverse treatment techniques are calculated and judged by means of multiplanar isodose representations.
The selected treatment plans are ranked with the aid of the dose-volume histograms. We distinguish the tissue inside and outside of the target volume.
The description of the spatial dose distribution in dependence of the different volumes and the respective fractions of the tumor dose therein with the help of dose-volume histograms brings about a correlation between the physical parameters and the biological effects. In addition one has to bear in mind the consequences of measures that influence the reaction and the side-effects of radiotherapy (e.g. chemotherapy), i.e. the recuperation of the tissues that were irradiated intentionally or inevitably. Taking all that into account it is evident that the dose-volume histograms are a powerful tool for assessing the quality of treatment plans.
小剂量分次照射大组织体积的组织耐受性预计与大剂量分次照射小组织体积的耐受性不同。必须制定相应的判断标准。
以食管癌为例,计算不同治疗技术的剂量体积直方图,并通过多平面等剂量表示法进行判断。
借助剂量体积直方图对所选治疗计划进行排序。我们区分靶区内和靶区外的组织。
借助剂量体积直方图描述空间剂量分布与不同体积以及其中肿瘤剂量的相应分次之间的关系,可建立物理参数与生物学效应之间的相关性。此外,必须牢记影响放疗反应和副作用(如化疗)的措施的后果,即有意或不可避免照射的组织的恢复情况。综合考虑所有这些因素,显然剂量体积直方图是评估治疗计划质量的有力工具。