评估前列腺床放射治疗的轮变异性和模拟治疗结果之间的关系
Viet Le Bao1,2, Annette Haworth3, Jason Dowling1,2
1South Western Clinical School, University of New South Wales, Sydney, Australia.
Physics in medicine and biology
|March 12, 2024
概括
轮相似度指标显示,前列腺放射治疗中与剂量计的联系较弱. 在临床目标体积轮中小于5毫米的变化对剂量计的影响最小,这表明在解释相似性得分时要谨慎.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 放射治疗规划 放射治疗规划
背景情况:
- 轮相似度指标在放射治疗中广泛用于观察者之间的变化和自动细分.
- 然而,这些指标往往无法评估轮变异对治疗结果的临床影响.
- 这项研究解决了需要将轮精度与前列腺切除术后放射治疗中的剂量测量后果联系起来.
研究的目的:
- 为了确定常见的轮相似度指标与前列腺切除术后放射治疗中的结果剂量之间的关系.
- 为了确定临床目标体积 (CTV) 轮的特定变化,这些变化会显著影响治疗剂量.
主要方法:
- 对10名前列腺切除术后患者的CT扫描进行了回顾性分析 (TROG 08.03 RAVES试验).
- 由三名观察员进行的CTV,直肠和膀的独立轮测量;使用STAPLE生成的参考体积.
- 用观察者,地图和参考体积创建的体积度调制弧线疗法 (VMAT) 计划;用放射生物学指标和DVHs评估的剂量测量. 系统地改变了PTV边际,以评估剂量计影响.
主要成果:
- 大多数相似度指标和模拟剂量计结果之间没有发现强烈的相关性.
- 在Dice,Jaccard和MDA指标和直肠毒性之间观察到中等相关性 (0.5 < Γ < 0.7).
- 在CTV轮变化中,扩张/收缩小于5毫米,显示出微小剂量计影响的趋势.
结论:
- 轮相似度指标应谨慎地解释为治疗计划变化的指标.
- 对于前列腺切除术后的VMAT,轮变化<5毫米并没有导致显著的剂量测量差异.
- 建议对更大的数据集进行进一步调查,以验证这些发现并评估可概括性.
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