Background
Methods
Delineation of target volumes and organs at risk
Radiotherapy dose prescription
Chemotherapy
Bone marrow delineation
Active bone marrow delineation on FDG-PET
Planning process
Parameter | Goal | |
---|---|---|
PTV | D95%
| ≥95% |
Dmax
| ≤107% | |
Bladder | V30
| <50% |
V40
| <35% | |
V50
| <5% | |
Large bowel | V30
| <200cm3
|
V35
| <150cm3
| |
V40
| <20cm3
| |
Dmax
| <50Gy | |
Small bowel | V30
| <200cm3
|
V35
| <150cm3
| |
V40
| <20cm3
| |
Dmax
| <50Gy | |
External genitalia | V20
| <50% |
V30
| <35% | |
V40
| <5% | |
Femural heads | V30
| <50% |
V40
| <35% | |
V50
| <5% | |
Iliac crests | V30
| <50% |
V40
| <35% | |
V50
| <5% |
Statistical analysis
Results
Variable | N° (%) |
---|---|
Age | |
Mean | 65 |
Rage | 50–78 |
Sex | |
Female | 5 (50%) |
Male | 5 (50%) |
T stage | |
T2 | 5 (50%) |
T3 | 5 (50%) |
N stage | |
N0–1 | 2 (20%) |
N2 | 6 (60%) |
N3 | 2 (20%) |
Global stage | |
II | 2 (20%) |
IIIB | 8 (80%) |
PTV dose-tumor (Gy) | |
54 Gy | 10 (100%) |
PTV dose-positive nodes (Gy) | |
54 Gy | 2 (20%) |
50.4 Gy | 5 (50%) |
PTV dose-elective volumes (Gy) | |
45 Gy | 10 (10%) |
Plan A | Plan B | Plan C | Plan D |
p ≤ 0.05 ANOVA | Fisher-Hayter test | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Structure | Parameter |
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
| ||
PBM |
D
max
| 53.50 | 2.30 | 53.57 | 2.20 | 53.55 | 2.13 | 53.73 | 2.09 | NS | |
D
mean
| 25.72 | 2.44 | 23.30 | 2.38 | 23.25 | 2.81 | 23.58 | 2.74 | NS | ||
LSBM |
D
max
| 48.56 | 2.17 | 48.83 | 1.79 | 49.21 | 1.88 | 49.27 | 1.95 | NS | |
D
mean
| 30.88 | 3.68 | 26.44 | 3.85 | 26.52 | 3.97 | 26.97 | 3.80 | 0.038 | A vs B and C | |
IBM |
D
max
| 48.64 | 3.04 | 48.89 | 3.17 | 49.35 | 2.99 | 49.16 | 3.21 | NS | |
D
mean
| 22.16 | 1.59 | 21.57 | 1.48 | 20.48 | 2.31 | 20.84 | 2.38 | NS | ||
V
30
| 24.58 | 4.74 | 24.65 | 3.76 | 21.14 | 6.60 | 22.06 | 7.36 | NS | ||
V
40
| 7.13 | 3.03 | 6.34 | 2.75 | 6.65 | 2.42 | 7.18 | 2.70 | NS | ||
V
45
| 1.15 | 1.90 | 1.09 | 2.15 | 1.49 | 1.53 | 1.45 | 1.81 | NS | ||
LPBM |
D
max
| 53.60 | 2.45 | 53.76 | 2.33 | 53.89 | 2.33 | 54.01 | 2.27 | NS | |
D
mean
| 25.99 | 4.12 | 23.76 | 4.36 | 24.46 | 4.62 | 24.60 | 4.48 | NS | ||
1- ACTPBM |
D
max
| 53.38 | 2.25 | 53.38 | 2.12 | 53.36 | 2.05 | 53.55 | 2.09 | NS | |
D
mean
| 22.70 | 3.58 | 20.21 | 3.40 | 21.18 | 3.92 | 21.56 | 3.79 | NS | ||
1-ACTLSBM |
D
max
| 48.32 | 2.17 | 48.60 | 1.85 | 48.94 | 1.90 | 48.95 | 2.00 | NS | |
D
mean
| 28.95 | 4.43 | 24.00 | 4.88 | 25.12 | 3.93 | 25.83 | 3.74 | NS | ||
1-ACTIBM |
D
max
| 48.60 | 3.06 | 48.70 | 3.32 | 49.24 | 3.07 | 49.06 | 3.17 | NS | |
D
mean
| 19.98 | 3.65 | 18.96 | 3.59 | 19.05 | 3.71 | 19.43 | 3.77 | NS | ||
1-ACTLPBM |
D
max
| 53.28 | 2.20 | 53.27 | 2.04 | 53.36 | 2.05 | 53.38 | 2.01 | NS | |
D
mean
| 21.85 | 4.16 | 19.60 | 3.88 | 20.77 | 4.82 | 21.06 | 4.60 | NS |
Plan A | Plan B | Plan C | Plan D |
p ≤ 0.05 ANOVA | Fisher-Hayter test | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Structure | Parameter |
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
| ||
ACTPBM |
D
max
| 52.67 | 2.72 | 52.93 | 2.82 | 53.03 | 2.79 | 53.18 | 2.63 | NS | |
D
mean
| 29.33 | 2.38 | 26.99 | 2.38 | 25.76 | 2.74 | 26.02 | 2.69 | 0.014 | A vs C and D | |
V
5
| 94.59 | 4.23 | 92.85 | 5.05 | 92.57 | 5.32 | 92.71 | 5.11 | NS | ||
V
10
| 87.84 | 6.04 | 85.10 | 7.10 | 84.05 | 7.73 | 84.35 | 7.53 | NS | ||
V
15
| 82.82 | 7.06 | 78.54 | 7.52 | 75.17 | 9.14 | 75.82 | 8.44 | NS | ||
V
20
| 74.26 | 7.13 | 68.58 | 6.94 | 63.50 | 8.59 | 64.24 | 8.43 | 0.015 | A vs C and D | |
V
25
| 63.49 | 7.48 | 56.35 | 6.90 | 51.49 | 7.52 | 52.18 | 7.97 | 0.030 | A vs C and D | |
V
30
| 52.63 | 7.17 | 44.87 | 6.71 | 40.27 | 7.12 | 41.31 | 7.71 | 0.020 | A vs C and D | |
V
35
| 41.72 | 6.78 | 33.35 | 6.13 | 30.06 | 6.43 | 31.14 | 6.73 | 0.010 | A vs B,C and D | |
V
40
| 28.82 | 5.67 | 21.54 | 5.10 | 19.94 | 7.27 | 20.67 | 5.24 | 0.020 | A vs B,C and D | |
V
45
| 9.16 | 3.51 | 7.64 | 2.75 | 7.20 | 2.83 | 6.91 | 2.21 | NS | ||
ACTLSBM |
D
max
| 48.46 | 2.01 | 48.66 | 1.51 | 49.08 | 1.70 | 49.13 | 1.54 | NS | |
D
mean
| 37.86 | 18.56 | 27.87 | 4.38 | 27.35 | 4.65 | 27.65 | 4.40 | NS | ||
V
5
| 89.89 | 8.72 | 87.71 | 9.16 | 87.24 | 9.48 | 87.43 | 9.30 | NS | ||
V
10
| 83.87 | 8.66 | 79.88 | 9.49 | 79.18 | 10.58 | 79.32 | 10.03 | NS | ||
V
15
| 79.94 | 9.09 | 74.87 | 9.99 | 74.19 | 11.68 | 74.46 | 10.64 | NS | ||
V
20
| 77.23 | 9.44 | 68.80 | 11.31 | 67.97 | 13.53 | 68.45 | 11.75 | NS | ||
V
25
| 73.13 | 10.15 | 60.88 | 12.60 | 59.46 | 14.15 | 60.71 | 12.54 | NS | ||
V
30
| 66.53 | 11.19 | 52.06 | 13.20 | 50.07 | 13.19 | 51.46 | 12.97 | 0.020 | A vs B,C and D | |
V
35
| 56.95 | 12.73 | 42.15 | 12.79 | 40.19 | 11.90 | 41.42 | 12.30 | 0.010 | A vs B,C and D | |
V
40
| 41.04 | 14.37 | 29.81 | 10.52 | 28.17 | 9.40 | 29.29 | 9.72 | 0.050 | A vs C | |
V
45
| 16.11 | 12.75 | 10.53 | 5.13 | 9.48 | 3.92 | 9.23 | 3.74 | NS |
Plan A | Plan B | Plan C | Plan D |
p ≤ 0.05 ANOVA | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Structure | Parameter |
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
|
Mean
|
SD(+/−)
| |
ACTIBM |
D
max
| 48.19 | 3.11 | 48.34 | 3.22 | 48.77 | 3.21 | 48.68 | 3.37 | NS |
D
mean
| 24.44 | 6.63 | 24.22 | 2.56 | 22.28 | 3.65 | 22.63 | 3.62 | NS | |
V
5
| 96.74 | 4.70 | 96.20 | 6.16 | 95.82 | 6.27 | 95.52 | 6.66 | NS | |
V
10
| 90.99 | 8.49 | 89.74 | 9.65 | 87.22 | 12.22 | 87.89 | 11.38 | NS | |
V
15
| 84.31 | 10.64 | 81.75 | 12.04 | 74.75 | 17.13 | 76.28 | 16.98 | NS | |
V
20
| 66.15 | 9.73 | 65.45 | 11.85 | 55.52 | 15.35 | 57.14 | 15.83 | NS | |
V
25
| 45.84 | 8.97 | 46.28 | 9.29 | 37.87 | 11.85 | 37.80 | 12.04 | NS | |
V
30
| 29.15 | 8.09 | 30.23 | 5.82 | 23.82 | 8.82 | 24.89 | 9.31 | NS | |
V
35
| 16.43 | 6.62 | 16.82 | 4.14 | 13.33 | 5.82 | 14.75 | 5.98 | NS | |
V
40
| 7.48 | 4.37 | 6.61 | 3.19 | 5.95 | 3.24 | 6.67 | 3.13 | NS | |
V
45
| 0.94 | 1.57 | 0.93 | 1.86 | 1.02 | 1.24 | 1.05 | 1.46 | NS | |
ACTLPBM |
D
max
| 52.66 | 2.71 | 52.93 | 2.82 | 53.00 | 2.86 | 53.14 | 2.70 | NS |
D
mean
| 33.09 | 4.61 | 30.63 | 4.70 | 29.34 | 4.80 | 29.54 | 4.63 | NS | |
V
5
| 98.30 | 3.37 | 96.93 | 5.11 | 97.15 | 5.66 | 98.01 | 4.14 | NS | |
V
10
| 90.09 | 9.01 | 88.32 | 9.85 | 89.50 | 9.28 | 88.95 | 10.05 | NS | |
V
15
| 86.12 | 10.76 | 82.13 | 12.69 | 80.73 | 14.49 | 81.07 | 12.61 | NS | |
V
20
| 82.07 | 12.89 | 76.19 | 13.85 | 71.53 | 15.41 | 72.34 | 14.82 | NS | |
V
25
| 75.68 | 14.62 | 67.33 | 14.57 | 61.89 | 15.33 | 63.45 | 15.46 | NS | |
V
30
| 66.78 | 15.38 | 57.91 | 14.86 | 51.34 | 13.93 | 52.29 | 14.28 | NS | |
V
35
| 55.63 | 15.81 | 46.22 | 13.29 | 40.63 | 12.42 | 41.33 | 12.55 | NS | |
V
40
| 38.94 | 12.30 | 32.28 | 10.88 | 29.06 | 10.86 | 29.37 | 10.56 | NS | |
V
45
| 16.98 | 7.53 | 14.15 | 6.52 | 13.54 | 7.12 | 12.89 | 8.85 | NS |