用于预测儿科患者辐射诱导白内障的剂量参数的比较
Siriphan Leangcharoensap1, Kullathorn Thephamongkhol1, Putthipong Chanwichu1
1Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
Journal of medical imaging and radiation oncology
|August 29, 2024
概括
平均透镜剂量 (Lens Dmean) ≥10 Gy最好预测儿童的辐射诱导白内障. 对Lens Dmean的门值<10 Gy可以减少不必要的治疗限制,同时错过更少的白内障病例.
科学领域:
- 眼科医生 眼科 眼科
- 辐射瘤学 辐射瘤学
- 儿科瘤学 儿科瘤学
背景情况:
- 儿科患者的放射治疗可能导致长期的副作用,包括白内障的形成.
- 准确预测辐射引起的白内障对于优化治疗计划和最大限度地减少眼睛毒性至关重要.
- 将不同的剂量指标进行比较 (镜头Dmax与镜头Dmax对比). 透镜 (Lens Dmean) 对于建立有效的剂量限制至关重要.
研究的目的:
- 为了比较各种透镜辐射剂量指标对儿科患者辐射诱导白内障的预测能力.
- 为了确定最准确的剂量值来预测白发育后骨或头和部辐射.
- 为了在儿科放射瘤学中建立最佳透镜剂量约束的信息.
主要方法:
- 对接受骨或头部放射治疗的儿科患者 (3-18岁) 的回顾性分析.
- 排除缺乏基线或后续眼科检查的患者.
- 利用接收器操作特征 (ROC) 曲线和考克斯回归来分析剂量反应关系并确定白内障的预测因子.
主要成果:
- 在平均4年的随访后,在11.5%的分析眼睛 (122个中14个) 检测到白内障.
- 平均透镜剂量 (Lens Dmean) ≥10 Gy与白内障形成有显著的关联.
- 三名患者 (21.4%) 患有≥3级白内障,表明明显的视力损伤.
结论:
- 透镜Dmean ≥10 Gy在儿科患者中显示了辐射诱导白内障的最高预测准确性.
- 将镜头剂量约束从Lens Dmax <7 Gy转变为Lens Dmean <10 Gy,可以将不必要的限制减少28%,同时只错过7%的白内障病例.
- 对于接受放射治疗的儿科患者,建议平均镜片剂量限制为<10 Gy,以平衡疗效和毒性.
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