Biological effective dose evaluation in gynaecological brachytherapy: LDR and HDR treatments, dependence on radiobiological parameters, and treatment optimisation

被引：10

作者：

Bianchi C. ^{[1
]}

Botta F. ^{[2
]}

Conte L. ^{[3
]}

Vanoli P. ^{[4
]}

Cerizza L. ^{[4
]}

机构：

[1] Servizio di Fisica Sanitaria, Ospedale di Circolo, Varese 21100

[2] Scuola di Specializzazione in Fisica Sanitaria, Università degli Studi di Milano, Milano

[3] Dipartimento di Scienze Cliniche e Biologiche, Università dell'Insubria, Varese

[4] Divisione di Radioterapia, Ospedale di Circolo, Varese

来源：

La radiologia medica | 2008年 / 113卷 / 7期

关键词：

BED; Brachytherapy; Gynaecological; Optimisation;

D O I：

10.1007/s11547-008-0291-4

中图分类号：

学科分类号：

摘要：

Purpose. This study was undertaken to compare the biological efficacy of different high-dose-rate (HDR) and low-dose-rate (LDR) treatments of gynaecological lesions, to identify the causes of possible nonuniformity and to optimise treatment through customised calculation. Materials and methods. The study considered 110 patients treated between 2001 and 2006 with external beam radiation therapy and/or brachytherapy with either LDR (afterloader Selectron, 137Cs) or HDR (afterloader microSelectron Classic, 192Ir). The treatments were compared in terms of biologically effective dose (BED) to the tumour and to the rectum (linear-quadratic model) by using statistical tests for comparisons between independent samples. Results. The difference between the two treatments was statistically significant in one case only. However, within each technique, we identified considerable nonuniformity in therapeutic efficacy due to differences in fractionation schemes and overall treatment time. To solve this problem, we created a Microsoft Excel spreadsheet allowing calculation of the optimal treatment for each patient: best efficacy (BED tumour) without exceeding toxicity threshold (BEDrectum). Conclusions. The efficacy of a treatment may vary as a result of several factors. Customised radiobiological evaluation is a useful adjunct to clinical evaluation in planning equivalent treatments that satisfy all dosimetric constraints. © 2008 Springer-Verlag.

引用

页码：1068 / 1078

页数：10

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