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- Olsson, Caroline, 1970
(författare)
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Radiation Oncology Data and Modelling Side Effects after Radiation Therapy
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although modern radiation therapy techniques have the ability to conform the dose distribution of ionizing radiation tightly around the volume to be treated, unwanted irradiation to surrounding organs remains a problem. The probability of a side effect arising in the normal tissue of a patient after radiation therapy can be modelled by sigmoid mathematical functions known as normal tissue complication probability (NTCP) models. Using statistical methods, these are fitted to input data representing the absence or presence of a studied symptom associated with the side effect in question and the dose distribution for potentially injured organs. NTCP models are increasingly being used in the clinic both for treatment evaluation and to guide optimization algorithms for inverse treatment planning although their predictions are associated with uncertainties to varying degrees. The purpose of this thesis is to investigate how different means to represent dose and ways to grade side effects contribute to uncertainties in radiation therapy side effect modelling. Using concepts from the literature and results from two recent Swedish studies including data on parotid gland complications in head and neck cancer patients and pubic bone pain in gynaecological cancer patients, respectively, current generations and representations of dose and side effect data and how these are used in modelling side effects are surveyed. Using similarities and differences in the data by the literature and these two studies, it is concluded that dose data for modelling purposes today is described by dose-volume histograms but can be made more detailed using a three-dimensional format like the structure-specific dose matrix as introduced in this thesis with additional information on dose representation. Side effect data are described by different scales to grade the same or similar symptoms, but also need to include information on factors which may influence modelling results such as effect-modifying factors as well as baseline symptom frequencies in non-irradiated individuals. Altogether, 15 items that capture the essential information needed for radiation therapy side effect modelling are identified, and the outlook for data integration and interoperability in radiation oncology would be improved by using these to form a semantic basis for this domain.
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| 2. |
- Waldenström, Ann-Charlotte, 1950, et al.
(författare)
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Relative importance of hip and sacral pain among long-term gynecological cancer survivors treated with pelvic radiotherapy and their relationships to mean absorbed doses.
- 2012
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : Elsevier. - 0360-3016 .- 1879-355X. ; 84:2, s. 428-436
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the relative importance of patient-reported hip and sacral pain after pelvic radiotherapy (RT) for gynecological cancer and its relationship to the absorbed doses in these organs.METHODS AND MATERIALS: We used data from a population-based study that included 650 long-term gynecological cancer survivors treated with pelvic RT in the Gothenburg and Stockholm areas in Sweden with a median follow-up of 6 years (range, 2-15) and 344 population controls. Symptoms were assessed through a study-specific postal questionnaire. We also analyzed the hip and sacral dose-volume histogram data for 358 of the survivors.RESULTS: Of the survivors, one in three reported having or having had hip pain after completing RT. Daily pain when walking was four times as common among the survivors compared to controls. Symptoms increased in frequency with a mean absorbed dose >37.5 Gy. Also, two in five survivors reported pain in the sacrum. Sacral pain also affected their walking ability and tended to increase with a mean absorbed dose >42.5 Gy.CONCLUSIONS: Long-term survivors of gynecological cancer treated with pelvic RT experience hip and sacral pain when walking. The mean absorbed dose was significantly related to hip pain and was borderline significantly related to sacral pain. Keeping the total mean absorbed hip dose below 37.5 Gy during treatment might lower the occurrence of long-lasting pain. In relation to the controls, the survivors had a lower occurrence of pain and pain-related symptoms from the hips and sacrum compared with what has previously been reported for the pubic bone.
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