论文标题
预测放射治疗后低度胶质瘤的再生
Predicting regrowth of low-grade gliomas after radiotherapy
论文作者
论文摘要
弥漫性低级神经胶质瘤是侵入性且无法治愈的脑肿瘤,不可避免地转化为高级肿瘤。延迟这种过渡的经典治疗方法是放疗(RT)。在RT之后,肿瘤在通常6个月至4年的时间内逐渐收缩。为了改善患者与健康相关的生活质量并帮助临床医生建立个性化的随访,可以从预计肿瘤减少的时间的预测中受益。挑战是在RT之后不久(即很少的数据)提供可靠的估计,尽管患者对治疗的反应有所不同。为此,我们从20个高质量的纵向数据中分析了肿瘤大小的动力学,并提出了一个仅使用4个参数的简单而健壮的分析模型。根据对它们的相关性的研究,我们建立了一个统计约束,即使对于患者,我们只有少量测量肿瘤大小的患者也有助于确定再生时间。我们验证数据上的过程,并在RT之后的第一个MRI时预测重生时间,通常为6个月。使用虚拟患者,我们研究RT后三个月仍然可以进行一些预测。我们获得了75%的重生时间的一些可靠估计,尤其是所有“快速响应者”。其余的25 \%代表实际再生时间较大的情况,一年后可以通过另一项测量来安全地估算。这些结果表明,在RT后不久,对肿瘤再生时间进行个性化预测的可行性。
Diffuse low grade gliomas are invasive and incurable brain tumours that inevitably transform into higher grade ones. A classical treatment to delay this transition is radiotherapy (RT). Following RT, the tumour gradually shrinks during a period of typically 6 months to 4 years before regrowing. To improve the patient's health-related quality of life and help clinicians build personalised follow-ups, one would benefit from predictions of the time during which the tumour is expected to decrease. The challenge is to provide a reliable estimate of this regrowth time shortly after RT (i.e. with few data), although patients react differently to the treatment. To this end, we analyse the tumour size dynamics from a batch of 20 high-quality longitudinal data, and propose a simple and robust analytical model, with just 4 parameters. From the study of their correlations, we build a statistical constraint that helps determine the regrowth time even for patients for which we have only a few measurements of the tumour size. We validate the procedure on the data and predict the regrowth time at the moment of the first MRI after RT, with precision of, typically, 6 months. Using virtual patients, we study whether some forecast is still possible just three months after RT. We obtain some reliable estimates of the regrowth time in 75\% of the cases, in particular for all "fast-responders". The remaining 25\% represent cases where the actual regrowth time is large and can be safely estimated with another measurement a year later. These results show the feasibility of making personalised predictions of the tumour regrowth time shortly after RT.