Application of TCP/NTCP biological models in intensity-modulated radiotherapy for middle and upper esophageal carcinoma(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2022年第3期
- Page:
- 265-272
- Research Field:
- 医学放射物理
- Publishing date:
Info
- Title:
- Application of TCP/NTCP biological models in intensity-modulated radiotherapy for middle and upper esophageal carcinoma
- Author(s):
- LAI Kaijian1; GONG Guanzhong2; WU Hui3; QUAN Hong1; YIN Yong2
- 1. School of Physics and Technology, Wuhan University, Wuhan 430072, China 2. Department of Medical Physics and Technology, Shandong Cancer Hospital, Jinan 250117, China 3. Department of Radiation Oncology, Henan Cancer Hospital, Zhengzhou 450008, China
- Keywords:
- Keywords: esophageal cancer plan optimization biological model dosimetry
- PACS:
- R318；R815.6
- DOI:
- DOI:10.3969/j.issn.1005-202X.2022.03.001
- Abstract:
- Abstract: Objective To explore the application of tumor control probability/normal tissue complication probability (TCP/NTCP) biological models in the optimization of radiotherapy plans for middle and upper thoracic esophageal cancer, and to analyze the dosimetric characteristics. Methods A total of 47 patients with middle and upper thoracic esophageal cancer were selected retrospectively, and the intensity-modulated radiotherapy plan based on dose-volume (DV) limits was developed for each patient. Based on the DV plan, the TCP biological models (with limit values of 90% and 95%) for the planning target volume (PTV) and the NTCP biological models (with limit values of 10% and 5%) for the organs-at-risk (OAR) were added to generate 4 sets of plans, namely [PlanTCP90%], [PlanTCP95%], [PlanNTCP10%] and [PlanNTCP5%]. The differences in dosimetric and biological parameters between different plans were evaluated. Results Compared with those in DV plans, the dosimetric parameters of PTV in [PlanTCP90%] and [PlanTCP95%] were increased (P<0.05), in which the [Dmean]、[D2%] and [D98%] were increased by (2.1%, 9.8%), (1.9%, 9.8%) and (1.7% 9.3%), respectively, and the TCP was increased by 2% and 7%, respectively, but conformity index was decreased by 5% and 20%, and homogeneity index was similar in the 3 sets of plans. The radiation doses to OAR were increased in different degrees, and the increase in [PlanTCP95%] was more significant (P<0.05). After TCP optimization, only [PlanTCP90%] could meet the clinical requirements. The dosimetric parameters of PTV and heart in [PlanNTCP5%] and DV plan were basically the same（P>0.05）, but the [Dmean]、[V5 Gy]、[V10 Gy]、[V20 Gy] and NTCP for both lungs in [PlanNTCP5%] were decreased by 4.4%, 1.6%, 2.6%, 6.2% and 0.52% as compared with DV plan (P<0.05). The differences in the dose parameters of PTV and OAR between [PlanNTCP10%] [and ]DV plan were trivial (P>0.05). Conclusion TCP/NTCP biological optimization can make the dose to the target areas and OAR more in line with the biological requirements. It is suggested that the evaluation of TCP/NTCP should be introduced after the optimization of DV plan of radiotherapy for middle and upper thoracic esophageal cancer, and furthermore, the selective targeted in-depth optimization should be carried out.
Last Update: 2022-03-28