在接受基于图像的宫癌支臂治疗的患者中,S点 (西格) 剂量和与晚期直垂西格不良事件的相关性:临床结果
Prachi Mittal1, J Kamalnath2, Mayuri Charnalia2
1Department of Radiation Oncology and Medical Physics, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Brachytherapy
|February 26, 2026
概括
一个新的"sigmoid点" (点S) 准确地预测了宫癌患者的直-sigmoid毒性. 剂量达到75 Gy3以上的S点显著与严重出血风险增加相关,为治疗计划提供了新的指标.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 妇科瘤学 妇科瘤学
背景情况:
- 图像引导式支臂疗法 (BT) 使用直肠和西格莫伊德的剂量限制,但西格莫伊德剂量毒性数据有限.
- 确立了直肠剂量毒性,而不是西格莫伊德剂量毒性.
- 由于sigmoid的位置可变性,一个"sigmoid点" (S点) 被提议作为替代标记.
研究的目的:
- 为了前性地验证西格点 (S点) 和晚期直-西格不良事件 (AE) 之间的关联.
- 为了评估点S作为一个替代标记在brachytherapy中sigmoid剂量.
- 评估各种剂量指标与晚期副作用的发生之间的相关性.
主要方法:
- 包括用化学辐射和基于MRI的BT治疗的宫癌患者.
- 通过使用CTCAE v4.4进行前性记录的晚期直垂体西格莫体AE.
- 在BT计划上追溯识别了S点,并计算了2Gy分数 (EQD2) 的等效剂量,用于直肠2cc,西格体2cc/0.1cc和S点.
- 进行了单变量分析,以将剂量与AE相关联.
主要成果:
- 在60名患者中,有9名患者 (15%) 发生了2级以上的直至西格莫体出血.
- 中位数EQD2剂量为直肠2cc,西格2cc和西格0.1cc,在患有低级和高级AE的患者之间没有显著差异.
- 只有S点剂量≥75 Gy3显著与2级≥2级直至西格出血的风险增加有关 (p=0.017).
- 后勤回归证实,较高的S点剂量增加了≥2级出血的可能性 (p<0.003).
结论:
- 西格点 (S点) 是一个有前途的替代品,用于估计在手臂治疗期间的西格剂量.
- 一个≥75 Gy3的S点剂量显著与≥2级直至西格毒性更高的风险有关.
- 在BT治疗计划中,S点提供了一种潜在的更准确的方法来预测Sigmoid毒性.
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