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研究生:劉華姍
研究生(外文):Hua-Shan Liu
論文名稱:利用平行性器官生物機率模型分析正常肝細胞因放射線照射產生併發症機率大小之研究
論文名稱(外文):Analysis of Radiation-Induced Liver Disease Using the Parallel Architecture NTCP Model
指導教授:鍾孝文
指導教授(外文):Hsiao-Wen Chung
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:電機工程學研究所
學門:工程學門
學類:電資工程學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:75
中文關鍵詞:生物機率模型平行性器官
外文關鍵詞:parallel architectureNTCP model
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在臨床放射線治療計劃的設計上,一個可靠而且安全的治療計劃是希望能夠達到將放射線的高劑量區集中在腫瘤部分,同時希望避開腫瘤附近的正常組織,使正常組織的吸收劑量降到最低,以達到除去腫瘤而且兼顧保護正常細胞弁鄋熙戽蚰堛滿C因為這個重要的理由,我們期待藉由這個研究,代入現有病人的劑量體積資料,來找出最適合的參數組合,建立一個放射線生物機率的模型,將輻射生物效應加以定量之。在這個研究中,我們引入的是由平行性器官特性所導證出的平行性器官的正常組織併發症機率模型(The parallel architecture NTCP model),這個機率模型的基本假設是建立在一個照射體積閥值的觀念上,如果一個正常組織接受放射線照射後,所受到的傷害體積經過放射線劑量的加權超過既定的閥值,那麼這個正常器官的弁鉥N會受到影響,反之,如果正常組織受到傷害的體積沒有超過閥值,那麼整個正常器官的弁鉥N得以保存下來。這個研究主要放入四組不同的正常肝細胞的劑量體積資料,這四組體積資料是由兩種不同病理特徵(肝癌和胃癌)的病人群體,再利用有沒有B型肝炎的帶原再分成共四小組子群體。利用統計方法中的最大可能性法(maximum likelihood method),我們分別找到了4組最佳的參數組合,代入傷害體積的計算公式,發現四組中有併發症的病人其計算出的傷害體積值皆在0.4以上。但是只有未帶原B型肝炎的2組病人群體,其有無併發症的傷害體積值才有明顯的差別,也就是說,如果不把人數的限制列入考量的範圍,只有這兩組病人群體才能比較合理的以此種機率模型解釋之。
An optimized treatment plan procedure of radiation therapy (RT) is done by delivering a sufficient dose of radiation to eradicate cancerous cells without having severe complication in healthy organs. For this reason, radiobiological models should be introduced to quantify the radiobiological response of normal tissues to radiotherapy. To predict the incidence of radiation-induced disease in parallel organs, the parallel architecture normal tissue complication probability (NTCP) model hypothesizes that a complication would be caused if the damaged fraction of the organ volume (f) exceeds the threshold of a critical one, ft (the “ functional reserve”). This study analyzed data of normal liver function from 4 patient subgroups with the parallel NTCP model to investigate the tolerance of the partial liver irradiation by evaluating the value of f. The calculated f from maximum likelihood estimated (MLE) parameters shows that cases of radiation-induced liver disease (RILD) have been reported in patients with a value of f larger than 0.4.
English Abstract
Chinese Abstract

1. INTRODUCTION….………………………………………………….5

2. THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY
(3DCRT)……………………………………………………………….7

2-1. Localization and immobilization of a treatment position
for the patient……………………………………………………..9

2-2. CT imaging……………………………………………………….10

2-3. Delineation of target volume……………………………………..11

2-4. Beam designing and dose calculation…………………………….12

2-5. Plan optimization and evaluation…………………………………13

3. MATERIALS AND METHODS……………………………………....33

3-1.Patients…………………………………………………………….33

3-2. Parallel Architecture NTCP Model……………………………….34

3-3. The Method of Maximum Likelihood……………...…………….38

3-4. Goodness of fit……………………………………………………41


4. RESULT………………………………………………………………49
4.1. MLE parameters, confidence intervals and goodness of fit……...49
4.2 MLE NTCP and calculated damaged fractional volume………….51
4.3 Observed vs. predicted complication rate…………………………52
4.4 Threshold of damaged fractional volume and irradiated dose……53

5. DISCUSSION………………………..………………………………..67

6. CONCLUSION………………………………………………………..73

APPENDIX
REFERENCES………………………………………………………..….75
1.Niemierko, A. and M. Goitein, Modeling of normal tissue response to radiation: the critical volume model. Int J Radiat Oncol Biol Phys, 1993. 25(1): p. 135-45.
2.Lawrence, T.S., et al., The use of 3-D dose volume analysis to predict radiation hepatitis. Int J Radiat Oncol Biol Phys, 1992. 23(4): p. 781-8.
3.Jackson, A., et al., Analysis of clinical complication data for radiation hepatitis using a parallel architecture model. Int J Radiat Oncol Biol Phys, 1995. 31(4): p. 883-91.
4.Dawson, L.A., et al., Analysis of radiation-induced liver disease using the Lyman NTCP model. Int J Radiat Oncol Biol Phys, 2002. 53(4): p. 810-21.
5.Cheng, J.C., et al., Radiation-induced liver disease after three-dimensional conformal radiotherapy for patients with hepatocellular carcinoma: dosimetric analysis and implication. Int J Radiat Oncol Biol Phys, 2002. 54(1): p. 156-62.
6.Levitt, S.H. and N.d. Tapley, Levitt and Tapley''s technological basis of radiation therapy : clinical applications. 3rd ed. 1999, Philadelphia: Williams & Wilkins. xiv, 560.
7.International Commission on Radiation Units and Measurements., Prescribing, recording, and reporting photon beam therapy. ICRU report ; 50. 1993, Bethesda, Md., U.S.A.: International Commission on Radiation Units and Measurements. viii, 72 p.
8.Jackson, A., G.J. Kutcher, and E.D. Yorke, Probability of radiation-induced complications for normal tissues with parallel architecture subject to non-uniform irradiation. Med Phys, 1993. 20(3): p. 613-25.
9.Yorke, E.D., et al., Probability of radiation-induced complications in normal tissues with parallel architecture under conditions of uniform whole or partial organ irradiation. Radiother Oncol, 1993. 26(3): p. 226-37.
10.Wetherill, G.B., Intermediate statistical methods. 1981, London ; New York: Chapman and Hall. xv, 390.
11.Silvey, S.D., Statistical inference. Reprinted with corrections. ed. Monographs on statistical subjects. 1975, London New York: Chapman and Hall ; Wiley. 192 p
12.Roberts, S.A. and J.H. Hendry, The delay before onset of accelerated tumour cell repopulation during radiotherapy: a direct maximum-likelihood analysis of a collection of worldwide tumour-control data. Radiother Oncol, 1993. 29(1): p. 69-74.
13.Seppenwoolde, Y., et al., Comparing different NTCP models that predict the incidence of radiation pneumonitis. Normal tissue complication probability. Int J Radiat Oncol Biol Phys, 2003. 55(3): p. 724-35.
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