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在前列腺放射治疗3个月后,NTCP建模和显著血红素水平下降的剂量-体积相关性

Panos Papanikolaou¹, Gregory Swanson², Sotirios Stathakis³

¹Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Advances in radiation oncology

|January 31, 2024

概括

前列腺癌的放射治疗可以通过损害盆骨髓导致血红素水平下降. 将辐射剂量限制在高于乙烯基体 (OCUB) 的骨上,可以降低这种风险.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
血液学血液学血液学

背景情况:

前列腺癌的盆腔放射治疗 (RT) 可以导致血红素水平下降.
了解盆腔结构的剂量反应关系对于减轻这种副作用至关重要.

研究的目的:

确定和建模盆腔RT和血红素水平降低之间的剂量反应关系.
为了确定与血红素变化相关的特定的骨盆结构和剂量限制.

主要方法:

分析了221名接受RT治疗的前列腺腺癌患者队列.
血红素水平在基线和RT后3个月被测量.
剂量反应建模使用相对序列性正常组织并发症概率模型和生物等效均剂量 (BED).

主要成果:

显著的血红素下降与辐射剂量对骨双边高于乙烯基体 (OCUB),总骨和整个骨盆骨量相关.
OCUB显示了最高的相关性 (AUC 0.74).
降低风险的门包括V20 Gy < 30%,平均剂量 (Dmean) < 23 Gy,或BED < 27 Gy到OCUB.

结论:

骨髓受辐射引起的损伤与血红素水平下降有关.
实施对OCUB的剂量限制 (V20 Gy < 30%,Dmean < 23 Gy,或BED < 27 Gy) 可以显著降低血位数下降的风险.

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