活体骨髓剂量重建在癌症患者接受光子放射治疗的大规模队列研究中
Keith T Griffin1, Kishan J Pithadia1,2, Yeon Soo Yeom3
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Journal of applied clinical medical physics
|February 24, 2026
概括
这项研究引入了一种方法,用于计算使用电子病历 (EMR) 的活跃骨髓 (ABM) 剂量,用于外部光束放射治疗 (EBRT) 患者. 这种方法为研究白血病风险和其他健康影响提供了更准确的辐射暴露量.
科学领域:
- 医学物理 医学物理
- 辐射瘤学 辐射瘤学
- 流行病学 流行病学
背景情况:
- 之前关于外部光束放射治疗 (EBRT) 和白血病风险的研究依赖于估计的活性骨髓 (ABM) 剂量.
- 电子医疗记录 (EMR) 尚未用于重建EBRT患者的ABM剂量和剂量体积指标.
研究的目的:
- 从EMR数据开发和演示一个追溯方法来计算ABM剂量和剂量体积指标.
- 支持对EBRT患者的辐射暴露和不良健康结果的未来研究.
主要方法:
- 获取了639名癌症患者的EMR,这些患者接受了光子放射治疗 (2003-2011).
- 使用3D骨注册与计算幻影重建骨部位轮.
- 使用患者特异性数据和治疗计划系统的剂量分布计算了ABM剂量和剂量量量指标.
主要成果:
- 成功对478名患者的骨数据进行了细分.
- 盆腔照射产生了最高的平均ABM剂量 (0.1820-0.2870 Gy/Gy_Rx),而内照射产生了最低的 (0.0030-0.0391 Gy/Gy_Rx).
- 平均ABM剂量很难反映剂量分布;99百分位数的剂量明显高于平均剂量.
结论:
- 开发了一种可扩展的基于EMR的方法,用于重建EBRT患者的ABM剂量和剂量体积指标.
- 这种方法捕捉了剂量异质性,为白血病发生研究提供了比平均ABM剂量更具信息性的暴露变量.
- 未来的工作将提高针对特定治疗场所和儿科患者群体的概括性.
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