对视神经缩的剂量对应关系在低剂量速率上 乳膜黑色素瘤的手臂治疗
Maja Guberina1, Martin Stuschke1, Dirk Flühs2
1Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
概括
这项研究澄清了视觉神经缩的剂量-反应关系,在膜黑色素瘤的手臂治疗后. 这些发现有助于估计患者在视神经附近接受辐射的风险.
科学领域:
- 眼科医生 眼科 眼科
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 之前,对于后膜黑色素瘤的支臂治疗后的视神经病变和缩的剂量反应关系未被定义.
- 这项研究分析了基于剂量计因素,应用器类型和瘤特征的结果差异.
研究的目的:
- 为了评估应用辐射剂量与视神经缩的发作之间的关联,在后面阴膜黑色素瘤的支臂治疗后进行支臂治疗.
- 为了能够对接受这种治疗的新患者进行风险估计.
主要方法:
- 对109名患者进行了回顾性分析,这些患者用-106的应用器治疗了后面阴道膜黑色素瘤.
- 使用专用软件和 fundus 照片重建视神经剂量分布.
- 权重后勤回归分析以确定剂量-反应关系.
主要成果:
- 视神经缩发生在29名患者身上,治疗后18个月的中位数开始.
- 在最大光盘剂量 (ODmax) 和视神经缩 (p=0.0001) 之间发现了显著的剂量反应关系.
- 视神经缩的50%概率剂量 (ED50) 根据应用器的类型而异,为77.6 Gy 口COB和53.2 Gy 其他应用器.
结论:
- 对于低剂量速率胸膜疗法,建立了视神经缩的显著剂量反应曲线.
- 一个标准的COB应用器位置允许从膜剂量估计剂量-反应,帮助风险评估没有 fundus 照片.
- 这项研究扩大了对视神经附近辐射暴露的剂量反应关系的理解.
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