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节省磁共振成像定义的活跃骨髓剂量-体积参数预测骨盆恶性瘤患者的血液毒性接受放射治疗的患者:一组研究

Ting Gao¹, Liqun Wei¹, Li Jiang¹

¹Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.

Technology in cancer research & treatment

|May 16, 2024

概括

磁共振成像 (MRI) 定义的活跃骨髓 (ABM) 剂量参数比计算机断层扫描 (CT) 定义的总骨髓 (TBM) 更好地预测盆腔癌放射治疗中的血液毒性 (HT). 这一发现可以改善患者的治疗结果和治疗计划.

科学领域:

辐射瘤学辐射瘤学
医疗成像医学成像
血液学血液学血液学

背景情况:

对于恶性瘤的盆腔放射治疗可以导致血液毒性 (HT).
准确预测HT对于治疗计划和患者管理至关重要.
目前使用计算机断层扫描 (CT) 定义的总骨髓 (TBM) 的方法可能缺乏精度.

研究的目的:

通过磁共振成像 (MRI) 定义的活跃骨髓 (ABM) 的剂量-体积参数的预测值与CT定义的HT发生的TBM进行比较.
为了确定基于MRI的ABM参数是否能比基于CT的TBM参数更好地预测HT.

主要方法:

对116名患有盆腔恶性瘤的患者进行了回顾性分析,这些患者接受了盆腔放射治疗.
在T1加权的MRI上 ABM和CT上 TBM的轮.
使用t测试或Wilcoxon签名等级测试,ABM和TBM之间的剂量-体积参数 (V5-V50) 的统计比较.
逻辑和线性回归模型来评估与HT和血液计数最低值的相关性.
接收器操作特征 (ROC) 曲线分析用于HT2+预测.

主要成果:

在ABM和TBM之间的剂量参数中观察到显著的差异.
ABM V5,V10,V15,V20和TBM V5与HT2+显著相关.
ABM V5,V10,V15与白细胞 (WBC),绝对中性粒细胞数 (ANC),血红蛋白 (Hb) 和淋巴细胞 (Lym) 的最低值有显著的相关性.
ABM V5,V10,V15 和 V30 是对HT2+的预测.

结论:

从基于MRI的ABM中获得的剂量-体积参数,在接受盆腔放射治疗的患者中提供更准确的HT预测.
这种方法可以提高放射治疗规划和毒性管理的精度.
需要进行前性研究来验证这些发现.

关键词:

有活性的骨髓.血液学毒性血液学毒性盆腔骨髓骨髓骨髓骨髓盆腔恶性瘤盆腔恶性瘤辐射疗法辐射疗法

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