中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2013年
6期
455-459
,共5页
王谨%包勇%庄婷婷%张黎%何智纯%台安%马红莲%胡晓%周琦超
王謹%包勇%莊婷婷%張黎%何智純%檯安%馬紅蓮%鬍曉%週琦超
왕근%포용%장정정%장려%하지순%태안%마홍련%호효%주기초
癌,非小细胞肺/同期放化疗法%放射性肺损伤%预测模型
癌,非小細胞肺/同期放化療法%放射性肺損傷%預測模型
암,비소세포폐/동기방화요법%방사성폐손상%예측모형
Carcinoma,non-small cell lung/concurrent radio-chemotherapy%Radiation induced lung injury%Forecasting model
目的 利用剂量体积直方图(DVH)参数建立Logistic剂量反应及Lyman-Kutcher-Burman正常组织并发症概率(LKB-NTCP)模型,并评估其对非小细胞肺癌同期放化疗后重度急性放射性肺炎(SARP)的预测价值.方法 搜集2006-2010年间行三维适形放疗同期化疗的147例非小细胞肺癌患者资料.按美国RTOG毒性评价标准定义超过3级的ARP为SARP.根据DVH剂量学信息建立Logistic剂量反应模型和LKB-NTCP模型.结果 SARP发生率为9.5％(14/147).Logistic剂量反应模型参数:常数b0=-6.66、b1=0.252,TD50=26.43 Gy,γ50=1.67；模型曲线在17 Gy以下相对平坦,17～18 Gy处变为陡峭,SARP风险增大.LKB-NTCP模型参数:体积效应因子n=0.87±0.40,曲线斜率倒数m=0.27 ±0.10,TD50(1)=(29.5±8.0)Gy;Logistic回归及ROC分析均发现此参数下计算出NTCP值对SARP有良好预测价值(P=0.013、0.019).结论 NTCP值对SARP的预测价值优于简单剂量参数,2个模型曲线均提示最大限制剂量在约17 Gy.
目的 利用劑量體積直方圖(DVH)參數建立Logistic劑量反應及Lyman-Kutcher-Burman正常組織併髮癥概率(LKB-NTCP)模型,併評估其對非小細胞肺癌同期放化療後重度急性放射性肺炎(SARP)的預測價值.方法 搜集2006-2010年間行三維適形放療同期化療的147例非小細胞肺癌患者資料.按美國RTOG毒性評價標準定義超過3級的ARP為SARP.根據DVH劑量學信息建立Logistic劑量反應模型和LKB-NTCP模型.結果 SARP髮生率為9.5％(14/147).Logistic劑量反應模型參數:常數b0=-6.66、b1=0.252,TD50=26.43 Gy,γ50=1.67；模型麯線在17 Gy以下相對平坦,17～18 Gy處變為陡峭,SARP風險增大.LKB-NTCP模型參數:體積效應因子n=0.87±0.40,麯線斜率倒數m=0.27 ±0.10,TD50(1)=(29.5±8.0)Gy;Logistic迴歸及ROC分析均髮現此參數下計算齣NTCP值對SARP有良好預測價值(P=0.013、0.019).結論 NTCP值對SARP的預測價值優于簡單劑量參數,2箇模型麯線均提示最大限製劑量在約17 Gy.
목적 이용제량체적직방도(DVH)삼수건립Logistic제량반응급Lyman-Kutcher-Burman정상조직병발증개솔(LKB-NTCP)모형,병평고기대비소세포폐암동기방화료후중도급성방사성폐염(SARP)적예측개치.방법 수집2006-2010년간행삼유괄형방료동기화료적147례비소세포폐암환자자료.안미국RTOG독성평개표준정의초과3급적ARP위SARP.근거DVH제량학신식건립Logistic제량반응모형화LKB-NTCP모형.결과 SARP발생솔위9.5％(14/147).Logistic제량반응모형삼수:상수b0=-6.66、b1=0.252,TD50=26.43 Gy,γ50=1.67；모형곡선재17 Gy이하상대평탄,17～18 Gy처변위두초,SARP풍험증대.LKB-NTCP모형삼수:체적효응인자n=0.87±0.40,곡선사솔도수m=0.27 ±0.10,TD50(1)=(29.5±8.0)Gy;Logistic회귀급ROC분석균발현차삼수하계산출NTCP치대SARP유량호예측개치(P=0.013、0.019).결론 NTCP치대SARP적예측개치우우간단제량삼수,2개모형곡선균제시최대한제제량재약17 Gy.
Objective To establish the Logistic dose response model and Lyman-Kutcher-Burman (LKB)-normal tissue complication probability (NTCP) model using dose-volume histogram (DVH) parameters and to evaluate their predictive values for severe acute radiation pneumonitis (SARP) in patients with non-small cell lung cancer (NSCLC) after concurrent chemotherapy and three-dimensional conformal radiotherapy (3DCRT).Methods The clinical data of 147 NSCLC patients who were treated with concurrent chemotherapy and 3DCRT from 2006 to 2010 were collected.According to RTOG criteria,grade 3 or even severer acute radiation pneumonitis was defined as SARP.The Logistic dose response model and LKB-NTCP model were established according to DVH dosimetric information.Results The incidence of SARP was 9.5％ (14/147).The best-fit parameter values for Logistic dose response model were shown as follows:constant b0 =-6.66;constant b1 =0.252;TD50 =26.43 Gy;γ50 =1.67.The fit curve was relatively flat when the maximum limit dose (MLD) was ＜ 17 Gy,and it became sharper when the MLD was 17-18 Gy,which implied that the risk of SARP increased.The best-fit parameter values for LKB-NTCP model were shown as follows:volume factor n=0.87 ± 0.40;slope factor m =0.27 ±0.10;TD50(1) =(29.5 ±8.0)Gy.The Logistic regression analysis and receiver operating characteristic (ROC) analysis showed that the NTCP value calculated using the parameter values had a good predictive value for SARP (Logistic regression:P =0.013 ;area under the ROC curve:0.707,P =0.019).Conclusions The predictive value of NTCP for SARP is better than simple dose parameters.The two model curves suggest that MLD is above 17 Gy.
