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在全乳腺放射治疗后,中度至严重的晚期副作用的皮肤剂量-体积预测因素

Alessandro Cicchetti¹, Paola Mangili², Andrei Fodor³

¹Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Data Science Unit, Milan, Italy.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

|February 29, 2024

概括

这项研究开发了一个模型来预测乳腺癌患者的放射治疗副作用,确定了诸如化品变化和皮肤辐射剂量等关键因素. 这有助于个性化治疗,改善患者的治疗结果.

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:

乳腺癌的放射治疗可能会导致显著的晚期毒性,影响患者的生活质量.
开发正常组织并发症概率 (NTCP) 的预测模型对于管理这些副作用至关重要.
这项研究的重点是利用剂量计和临床因素预测晚期皮肤毒性.

研究的目的:

开发和验证一个正常组织并发症概率 (NTCP) 模型,用于预测整个乳房放射治疗后晚期皮肤毒性.
确定乳腺皮肤的关键剂量参数和与中度至重度晚期副作用相关的临床因素.

主要方法:

一项对1066名乳腺癌早期患者的回顾性分析,这些患者接受了40 Gy/15分数接触场放射治疗.
皮肤结构定义为CT身体轮的5毫米内扩张;使用SOMA/LENT标准评估毒性.
一个机器学习管道利用后勤回归结合临床因素和绝对皮肤剂量-体积直方图 (DVH) 参数.

主要成果:

晚期中度至重度副作用的发生率 (纤维化 - 缩 - 长尾性质 - 疼痛,FATP G≥2) 为3.8% (40/1066名患者).
一个四变量模型确定了手术后的化品改变 (OR=7.3),芳酶抑制剂 (OR=0.45),V20 Gy (OR=1.02),和V42 Gy (OR=1.09) 作为重要的预测因素.
预测因素可以转换为调整后的V20Gy.

结论:

该研究量化了放射治疗后晚期皮肤反应和皮肤DVH参数 (V20 Gy,V42 Gy) 之间的关联.
发现特定的临床因素显著调节晚期毒性发展的风险.
开发的NTCP模型有助于预测和潜在地减轻放射治疗引起的皮肤并发症.

关键词:

乳房乳房乳房剂量耐受性剂量耐受性纤维化纤维化纤维化皮肤反应皮肤反应

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