在局部晚期宫癌的初级化疗后毒性的预测因素:系统性审查
Anouk Corbeau1, Wilma D Heemsbergen2, Sander C Kuipers3
1Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
International journal of radiation oncology, biology, physics
|November 18, 2023
概括
本综述确定了用化学辐射治疗治疗局部晚期宫癌 (LACC) 的女性胃肠道,泌尿器官和阴道毒性的关键预测因素. 这些发现将为个性化放射治疗提供正常组织并发症概率 (NTCP) 模型的信息.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 局部晚期子宫癌 (LACC) 治疗通常涉及化疗放射治疗和支臂疗法,导致显著的毒性.
- 正常组织并发症概率 (NTCP) 模型对于优化放射治疗和最小化副作用至关重要.
- 确定这些毒性的准确预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和识别患有LACC的妇女中胃肠道 (GI),尿道 (GU) 和阴道毒性的预测因素.
- 提供剂量-体积参数,患者特征和与治疗相关的毒性相关的治疗因素的概述.
- 为了帮助开发更准确的NTCP模型用于临床应用.
主要方法:
- 进行了系统的文献搜索,以确定评估LACC患者中毒性预测因素的研究.
- 使用"预后研究质量"工具评估研究是否存在偏差风险;排除了高风险研究.
- 分析了剂量-体积参数,患者/治疗特征和毒性终点之间的关系.
主要成果:
- 26项研究符合纳入标准,揭示了多种毒性预测因子.
- 胸膜治疗剂量-体积参数 (例如,直肠EQD2 D2 cm3) 和 (直) 阴道点剂量经常与GI,GU和阴道毒性有关.
- 外部光束辐射疗法参数 (例如直肠EQD2 V30 Gy) 和患者因素 (例如肥胖,阴道干扰) 也成为重要预测因素.
结论:
- 已经确定了在LACC患者中毒性的多个候选预测因子.
- 进一步的研究应该集中在不足骨折,外部束辐射治疗剂量水平和量化预测因子毒性关系上.
- 结合这些预测因素的增强NTCP模型可以促进LACC的个性化放射治疗.
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