Real-time morphological and dosimetric adaptation in nasopharyngeal carcinoma radiotherapy: insights from autosegmented fractional fan-beam CT

被引：0

作者：

Yu, Xiao-li ^{[1
,2
,3
,4
]}

Hu, Jiang ^{[1
,2
]}

Yang, Yu-xian ^{[1
,2
]}

Wang, Guang-yu ^{[1
,2
]}

Yang, Xin ^{[1
,2
]}

Diao, Wen-chao ^{[1
,2
]}

Liu, Lu ^{[1
,2
]}

Jiang, Xiao-bo ^{[1
,2
]}

Xu, Chen-di ^{[1
,2
]}

Lin, Liu-wen ^{[1
,2
]}

Jia, Le-cheng ^{[5
]}

Li, Hua ^{[5
]}

Liu, Yan-fei ^{[5
]}

Sun, Ying ^{[1
,2
]}

Zhou, Guan-qun ^{[1
,2
]}

机构：

[1] Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China

[2] Collaborat Innovat Ctr Canc Med, State Key Lab Oncol Southern China, 651 Dongfeng Rd East, Guangzhou 510060, Peoples R China

[3] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Radiat Oncol, Guangzhou 510120, Peoples R China

[4] Guangdong Prov Key Lab Malignant Tumor Epigenet &, Guangzhou 510120, Peoples R China

[5] Shenzhen United Imaging Res Inst Innovat Med Equip, Res Cooperat Dept, Shenzhen 518048, Peoples R China

来源：

RADIATION ONCOLOGY | 2025年 / 20卷 / 01期

关键词：

Morphology; Dosimetry; Autosegmentation; Fan-beam CT; Adaptive radiotherapy; Nasopharyngeal carcinoma; ADAPTIVE RADIATION-THERAPY; NECK-CANCER; SUBMANDIBULAR-GLANDS; HEAD; STRATEGIES; BENEFIT; ORGANS; VOLUME; IMPACT;

D O I：

10.1186/s13014-025-02643-6

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background To quantify morphological and dosimetric variations in nasopharyngeal carcinoma (NPC) radiotherapy via autosegmented fan-beam computed tomography (FBCT) and to inform decision-making regarding appropriate objectives and optimal timing for adaptive radiotherapy (ART). Methods This retrospective study analyzed 23 NPC patients (681 FBCT scans) treated at Sun Yat-sen Cancer Center from August 2022 to May 2024. The inclusion criterion was as follows: >= 1 weekly FBCT via a CT-linac with <= 2 fractions between scans. Four deep learning-based autosegmentation models were developed to assess weekly volume, Dice similarity coefficient (DSC), and dose variations in organs at risk (OARs) and target volumes. Results A systematic review of autosegmentation on FBCT scans demonstrated satisfactory accuracy overall, and missegmentation was manually modified. Linear decreases in volume and/or DSC were observed in the parotid glands, submandibular glands, thyroid, spinal cord, and target volumes (R-2 > 0.7). The linear dose variation included coverage of the low risk planning target volume (-3.01%), the mean dose to the parotid glands (+ 2.45 Gy) and thyroid (+ 1.18 Gy), the D1% of the brainstem (+ 0.56 Gy), and the maximum dose to the spinal cord (+ 1.12 Gy). The greatest reduction in target volume coverage was noted in PGTVns, reaching 7.15%. The most significant dose changes occurred during weeks 3-6. Conclusions During NPC radiotherapy, the progressive dose deviations may not be corrected through repositioning alone, necessitating ART intervention. As dose variations in OARs rarely exceed 3 Gy and target coverage fluctuations remain within 10%, ART does not need to be performed frequently, and weeks 3-6 represent the most appropriate window.

引用

页数：11