规划目标体积和有风险的器官内的观察者间变化在患有口腔瘤的患者中:用解剖学分析进行轮研究
Fabian Baier1, Oliver Koelbl1, Felix Steger1
1Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Regensburg, 93053 Regensburg, Germany.
Current oncology (Toronto, Ont.)
|January 27, 2026
概括
对于口腔瘤的放射治疗轮的观察者间变异性是显著的,特别是对于淋巴结和有风险的器官. 结构化的解剖学评估可以提高一致性和患者的治疗结果.
科学领域:
- 辐射瘤学 辐射瘤学
- 医疗成像医学成像
- 解剖学界线的划分
背景情况:
- 放射治疗规划中的观察者间变异性 (IOV) 影响治疗质量.
- 轮指南和先进的成像没有消除IOV在目标和器官划分.
研究的目的:
- 检查规划目标体积 (PTV) 和风险器官 (OAR) 划分的变化.
- 评估PTV中淋巴结水平包含的变异性.
主要方法:
- 十位放射瘤学家对一个口腔瘤患者的PTV和16个OAR进行了轮.
- 使用体积统计,变异系数 (CoV) 和符合指数 (CI) 来量化观察者间的变化.
主要成果:
- 在划分双侧淋巴结水平Ib-IVa和VIIa+b方面达成高度一致.
- 对于宫三角和关节节的显著差异.
- 在OAR中最大的变异性涉及内耳 (体积范围为0.11-2.84厘米3).
结论:
- 在口腔癌的PTV和OAR划分中仍然存在显著的IOV.
- 选择性淋巴结包容和边缘定义是导致IOV的关键因素.
- 结构化的解剖学评估可以最大限度地减少变异性,提高治疗的一致性.
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