Hypoxia dose painting by numbers: a planning study.

摘要: Purpose: To investigate the feasibility of different hypoxia dose painting strategies in head-and-neck radiotherapy; potential benefit was limited by stipulation isotoxicity with respect to conventional intensity-modulated radiotherapy (IMRT) treatment. Methods and Materials: Thirteen cancer patients were included into planning study. For each patient, three treatment plans created: a IMRT plan, an additional uniform escalation (uniDE) 10% fluorodeoxyglucose (FDG)-positive volume, plan which numbers (DPBN) implemented. Dose realized according map dose-escalation factors calculated from dynamic [ 18 F]-fluoromisonidazole (FMISO) positron emission tomography data. Results: Both approaches shown be feasible under constraint limiting normal tissue doses level IMRT. DPBN, prescriptions could fulfilled larger regions target than for uniDE. Fluorodeoxyglucose-positive volumes had sizes up 94 cm 3 . In contrast, receiving comparable levels DPBN presented range 0–2.7 Overtreatment observed uniDE most cases, whereas some did not receive required overcome hypoxia-induced radiation insensitivity. Tumor control probability increased 55.9% 57.7% method patient group. increase tumor 70.2% determined. Therefore, seems result higher benefits patients. Conclusion: delivers more effectively boost FDG-positive area. If adequately quantified simple imaging technique like FMISO tomography, substantially control.