[1]来凯建,巩贯忠,吴慧,等.TCP/NTCP生物模型在胸中上段食管癌调强放疗中的应用[J].中国医学物理学杂志,2022,39(3):265-272.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.001]
　LAI Kaijian,GONG Guanzhong,WU Hui,et al.Application of TCP/NTCP biological models in intensity-modulated radiotherapy for middle and upper esophageal carcinoma[J].Chinese Journal of Medical Physics,2022,39(3):265-272.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.001]
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TCP/NTCP生物模型在胸中上段食管癌调强放疗中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第3期
页码:
265-272
栏目:
医学放射物理
出版日期:
2022-03-28

文章信息/Info

Title:
Application of TCP/NTCP biological models in intensity-modulated radiotherapy for middle and upper esophageal carcinoma
文章编号:
1005-202X（2022）03-0265-07
作者:
来凯建1; 巩贯忠2; 吴慧3; 全红1; 尹勇2
1.武汉大学物理科学与技术学院， 湖北 武汉 430072； 2.山东省肿瘤医院放射物理技术科， 山东 济南 250117； 3.河南省肿瘤医院放疗科， 河南 郑州 450008
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
关键词:
食管癌; 计划优化; 生物模型; 剂量学
Keywords:
Keywords: esophageal cancer plan optimization biological model dosimetry
分类号:
R318；R815.6
DOI:
DOI:10.3969/j.issn.1005-202X.2022.03.001
文献标志码:
A
摘要:
目的：探究TCP/NTCP生物模型在胸中上段食管癌放疗计划优化中的应用及剂量学特点。方法：回顾性分析47例胸中上段食管癌患者，为每位患者制定基于剂量体积（DV）限制的IMRT计划，在DV计划基础上添加对计划靶区（PTV）的TCP（限值90%、95%）生物模型以及危及器官的NTCP（限值10%、5%）模型优化，依次生成[PlanTCP90%]、[PlanTCP95%]、[PlanNTCP10%]、[PlanNTCP5%]4组计划。从剂量学及生物学参数方面评估计划间差异。结果：[PlanTCP90%]、[PlanTCP95%]相比于DV计划，靶区剂量参数均提高（P<0.05），其中[Dmean]、[D2%]、[D98%]分别提高（2.1%、9.8%）、（1.9%、9.8%）和（1.7%、9.3%），CI分别降低5%、20%，HI相近，TCP值分别提高2%、7%；危及器官受照剂量均有不同程度提高，[PlanTCP95%]增加更显著（P<0.05）。经TCP优化后的计划仅[PlanTCP90%]满足临床要求；[PlanNTCP5%]与DV计划相比，靶区、心脏相关剂量参数间差异没有统计学意义（P>0.05），但双肺[Dmean]、[V5 Gy]、[V10 Gy]、[V20 Gy]、NTCP值降低4.4%、1.6%、2.6%、6.2%、0.52%（P<0.05）。[PlanNTCP10%]与DV计划相比，PTV及危及器官相关剂量学参数间差异没有统计学意义（P>0.05）。结论：TCP/NTCP生物学优化可以使靶区及危及器官剂量更符合生物学要求，建议在胸中上段食管癌放疗DV计划优化后引入TCP/NTCP的评估，进而进行选择性的靶向深入优化。
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.

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备注/Memo

备注/Memo:
【收稿日期】2021-07-19 【基金项目】国家自然科学基金（82072094）；山东省自然科学基金（ZR2019LZL017）；山东省泰山学者项目（ts201712098）；河南省医学科技攻关计划省部共建项目（SB201901112） 【作者简介】来凯建，在读硕士，主要研究方向：医学物理，E-mail: kaijian.lai@whu.edu.cn 【通信作者】尹勇，研究员，主要研究方向：放射物理，E-mail: yinyongsd@126.com；全红，副教授，主要研究方向：医学物理，E-mail: 00007962@whu.edu.cn
更新日期/Last Update: 2022-03-28