Half-Brain Delineation for Prediction of Radiation-Induced Temporal Lobe Injury in Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiotherapy

作者：Qinghua Du, Yi-Xiu Gan, Rensheng Wang, Wenqi Liu, Jian Li, Feifei Liang, Xiangde Li, Huijun Zhu, Xue Ou, Qiulu Zhong, Danjing Luo, Zhi-Peng Zhu, Shang-Yong Zhu · 发表于：Frontiers in Oncology · 年份：2021 · DOI：10.3389/fonc.2021.599942 · 被引用次数：6 · 研究领域：Brain Metastases and Treatment、Brain Tumor Detection and Classification、Advanced Computing and Algorithms

Purpose To investigate the role of half-brain delineation in the prediction of radiation-induced temporal lobe injury (TLI) in nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT). Methods and Materials A total of 220 NPC cases treated with IMRT and concurrent platinum-based chemotherapy were retrospectively analyzed. Dosimetric parameters of temporal lobes, half-brains, and brains included maximum dose (D max ), doses covering certain volume (D V ) from 0.03 to 20 cc and absolute volumes receiving specific dose (V D ) from 40 to 80 Gy. Inter-structure variability was assessed by coefficients of variation (CV) and paired samples t -tests. Receiver operating characteristic curve (ROC) and Youden index were used for screening dosimetric parameters to predict TLI. Dose/volume response curve was calculated using the logistic dose/volume response model. Results CVs of brains, left/right half-brains, and left/right temporal lobes were 9.72%, 9.96%, 9.77%, 27.85%, and 28.34%, respectively. Each D V in temporal lobe was significantly smaller than that in half-brain (P < 0.001), and the reduction ranged from 3.10% to 45.98%. The area under the curve (AUC) of D V and V D showed an “increase-maximum-decline” behavior with a peak as the volume or dose increased. The maximal AUCs of D V s in brain, half-brain and temporal lobe were 0.808 (D 2cc ), 0.828 (D 1.2cc ) and 0.806 (D 0.6cc ), respectively, and the maximal AUCs of V D s were 0.818 (D 75Gy ), 0.8...