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Prognostic value and predictive threshold of tumor volume for patients with locally advanced nasopharyngeal carcinoma receiving intensity-modulated radiotherapy 被引量:12
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作者 Yu-Xiang He Ying Wang +9 位作者 Peng-Fei Cao Lin Shen Ya-Jie Zhao Zi-Jian Zhang Deng-Ming Chen Tu-Bao Yang Xin-Qiong Huang Zhou Qin You-Yi Dai Liang-Fang Shen 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第12期725-734,共10页
Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NP... Background: Gross target volume of primary tumor(GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma(NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy(IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ind a suitable cut?of value of GTV?P for prognosis prediction.Methods: Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic(ROC) curves were used to identify the cut?of values of GTV?P for the prediction of diferent end?points [overall survival(OS), local relapse?free survival(LRFS), distant metastasis?free survival(DMFS), and disease?free survival(DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system.Results: The 358 patients with locally advanced NPC were divided into two groups by the cut?of value of GTV?P as determined using ROC curves: 219(61.2%) patients with GTV?P ≤46.4 mL and 139(38.8%) with GTV?P >46.4 mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P ≤46.4 mL than in those with GTV?P > 46.4 mL(all P < 0.05). Multivariate analysis indicated that GTV?P >46.4 mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriied that the predictive ability of GTV?P was superior to that of T category(P < 0.001). The cut?of values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4 mL, respectively.Conclusion: In patients with locally advanced NPC, GTV?P >46.4 mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category. 展开更多
关键词 Nasopharyngeal carcinoma Intensity-modulated radiotherapy gross target volume of primary tumor PROGNOSIS
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鼻咽癌原发肿瘤放疗靶区的自动分割 被引量:1
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作者 薛旭东 郝晓宇 +3 位作者 石军 丁轶 魏伟 安虹 《中国图象图形学报》 CSCD 北大核心 2020年第10期2151-2158,共8页
目的放射治疗是鼻咽癌的主要治疗方式之一,精准的肿瘤靶区分割是提升肿瘤放疗控制率和减小放疗毒性的关键因素,但常用的手工勾画时间长且勾画者之间存在差异。本文探究Deeplabv3+卷积神经网络模型用于鼻咽癌原发肿瘤放疗靶区(primary tu... 目的放射治疗是鼻咽癌的主要治疗方式之一,精准的肿瘤靶区分割是提升肿瘤放疗控制率和减小放疗毒性的关键因素,但常用的手工勾画时间长且勾画者之间存在差异。本文探究Deeplabv3+卷积神经网络模型用于鼻咽癌原发肿瘤放疗靶区(primary tumor gross target volume,GTVp)自动分割的可行性。方法利用Deeplabv3+网络搭建端到端的自动分割框架,以150例已进行调强放射治疗的鼻咽癌患者CT(computed tomography)影像和GTVp轮廓为研究对象,随机选取其中15例作为测试集。以戴斯相似系数(Dice similarity coefficient,DSC)、杰卡德系数(Jaccard index,JI)、平均表面距离(average surface distance,ASD)和豪斯多夫距离(Hausdorff distance,HD)为评估标准,详细比较Deeplabv3+网络模型、U-Net网络模型的自动分割结果与临床医生手工勾画的差异。结果研究发现测试集患者的平均DSC值为0.76±0.11,平均JI值为0.63±0.13,平均ASD值为(3.4±2.0)mm,平均HD值为(10.9±8.6)mm。相比U-Net模型,Deeplabv3+网络模型的平均DSC值和JI值分别提升了3%~4%,平均ASD值减小了0.4 mm,HD值无统计学差异。结论研究表明,Deeplabv3+网络模型相比U-Net模型采用了新型编码—解码网络和带孔空间金字塔网络结构,提升了分割精度,有望提高GTVp的勾画效率和一致性,但在临床实践中需仔细审核自动分割结果。 展开更多
关键词 自动分割 放射治疗 卷积神经网络 原发肿瘤放疗靶区 鼻咽癌
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