纵向基于voxel的分析确定了膀部子区域,预测前列腺癌再辐射后的生殖尿道毒性
Carlos Sosa-Marrero1, Jennifer Le Guévelou1, Manon Baty2
1Univ Rennes, CLCC Eugène Marquis, INSERM, LTSI - UMR 1099, F-35000 Rennes, France.
概括
针对前列腺癌再辐射的立体性身体辐射疗法 (SBRT) 确定了一个特定的膀部子区域,与更高的尿生殖系统 (GU) 毒性风险相关. 这一发现有助于完善治疗计划,以尽量减少副作用.
科学领域:
- 辐射瘤学 辐射瘤学
- 尿瘤学 尿瘤学
- 医学物理 医学物理
背景情况:
- 使用立体性身体辐射疗法 (SBRT) 进行前列腺癌再辐射,旨在保护处于危险的器官.
- 生殖尿路 (GU) 毒性是前列腺癌治疗中的一个问题.
- 确定与毒性相关的特定亚区域对于剂量优化至关重要.
研究的目的:
- 进行基于voxel的纵向分析,以确定尿道子子区域,在这些区域中,更高的计划剂量与晚期GU毒性风险的增加有关.
- 探索剂量体积图谱 (DVH) 对前列腺癌再辐射中的GU毒性的预测能力.
主要方法:
- 对108名因局部前列腺癌复发而接受救援SBRT治疗的患者进行了回顾性分析.
- 对3D剂量分配到共同空间的非刚性注册.
- 基于voxel的多变量分析,使用Cox回归来将剂量与毒性相关联.
主要成果:
- 确定了膀部的一个特定的亚区域,位于与内泌尿道关节的交叉点.
- 计划给该次区域的更高剂量与3级或更高的GU毒性风险显著增加有关.
- 这次子区域的DVH显示出较高的毒性预测性能 (AUC>0.8),与整个有风险的器官相比.
结论:
- 膀部的解剖学亚区域被确定为预测晚级≥3GU毒性.
- 这一发现可以告知SBRT计划,以减轻前列腺癌患者的GU毒性.
- 针对该次区域的向剂量限制可能会改善治疗结果.
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