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The influence of dose distribution on treatment outcome in the SCOPE 1 oesophageal cancer trial

机译:SCOPE 1食管癌试验中剂量分布对治疗结果的影响

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摘要

The first aim of this study was to assess plan quality using a conformity index (CI) and analyse its influence on patient outcome. The second aim was to identify whether clinical and technological factors including planning treatment volume (PTV) volume and treatment delivery method could be related to the CI value. By extending the original concept of the mean distance to conformity (MDC) index, the OverMDC and UnderMDC of the 95?% isodose line (50Gy prescribed dose) to the PTV was calculated for 97 patients from the UK SCOPE 1 trial (ISCRT47718479). Data preparation was carried out in CERR, with Kaplan-Meier and multivariate analysis undertaken in EUCLID and further tests in Microsoft Excel and IBM’s SPSS. A statistically significant breakpoint in the overall survival data, independent of cetuximab, was found with OverMDC (4.4?mm, p?
机译:这项研究的首要目的是使用合格指数(CI)评估计划质量并分析其对患者预后的影响。第二个目的是确定临床和技术因素,包括计划治疗量(PTV)量和治疗提供方法是否可能与CI值相关。通过扩展最初的平均符合距离(MDC)指数概念,​​从UK SCOPE 1试验(ISCRT47718479)计算出了97%的等剂量线(50Gy处方剂量)至PTV的OverMDC和UnderMDC。数据准备工作在CERR中进行,Kaplan-Meier和多元分析在EUCLID中进行,进一步的测试在Microsoft Excel和IBM SPSS中进行。使用OverMDC(4.4?mm,p?<?0.05),发现了总生存数据中具有统计学意义的断点,而与西妥昔单抗无关。 UnderMDC并非如此。 OverMDC断点两侧的PTV体积(Mann Whitney p <0.001)和OverMDC值在统计学上有显着差异(取决于IMRT?=?2.1?mm,平均3D-CRT?=)。 <4.1mm Mann Whitney p << 0.001)。根据OverMDC从3D-CRT到VMAT重新计划表现最差的患者,导致OverMDC平均减少2.8?mm(1.6-4.0?mm)。在包括年龄,性别,分期,肿瘤类型和位置在内的多变量分析中,OverMDC并不显着。尽管在多变量分析中纳入时并不显着,但在单变量分析中我们已经表明,患者的OverMDC与总体生存率相关。 OverMDC与IMRT密切相关,在较小程度上与PTV数量相关。我们建议在可行的情况下,将VMAT规划用于食道规划,并应注意95%符合PTV。

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