This biophysical study aimed to determine fitting parameters for the Lyman–Kutcher–Burman (LKB) dose–response model for normal tissue complication probability (NTCP) calculations of acute side effects and to investigate the impact of reduced radiation doses on the probability of their occurrence in supradiaphragmatic non-Hodgkin lymphoma (NHL) irradiation. A cohort of 114 patients with NHL in the cervicothoracic region, treated between 2015 and 2021 at the University Hospitals of Münster, Hamburg, and Essen, with involved site radiation therapy (ISRT), were included. Among them, 68 patients with aggressive NHL (a-NHL) received consolidative radiation therapy with 24–54 Gy following (R-)CHOP chemotherapy. Additionally, 46 patients with indolent NHL (i-NHL) underwent radiotherapy with 22.5–45.0 Gy. Two treatment plans were prospectively created for each patient (a-NHL: 30.0/40.0 Gy; i-NHL: 24.0/30.0 Gy). NTCP were then calculated using the optimized LKB model. The adapted dose–response models properly predicted the patient’s probability of developing acute side effects when receiving doses ≤ 50 Gy. In addition, it was shown that reduced radiation doses can influence the NTCP of acute side effects depending on the aggressiveness of NHL significantly. This study provided a foundation to prospectively assess the probability of adverse side effects among today’s reduced radiation doses in the treatment of NHL.
本研究旨在通过生物物理学方法，为Lyman–Kutcher–Burman（LKB）剂量反应模型确定适用于正常组织并发症概率（NTCP）计算的拟合参数，以评估膈上非霍奇金淋巴瘤（NHL）放疗中急性副作用的NTCP，并探究降低辐射剂量对其发生概率的影响。研究纳入了2015年至2021年间在明斯特大学医院、汉堡大学医院和埃森大学医院接受累及部位放疗（ISRT）的114例颈胸部NHL患者。其中，68例侵袭性NHL（a-NHL）患者在（R-）CHOP化疗后接受了24–54 Gy的巩固放疗；另外46例惰性NHL（i-NHL）患者接受了22.5–45.0 Gy的放疗。为每位患者前瞻性制定了两套放疗计划（a-NHL：30.0/40.0 Gy；i-NHL：24.0/30.0 Gy），并采用优化后的LKB模型计算NTCP。调整后的剂量反应模型能准确预测患者在接受≤50 Gy剂量时发生急性副作用的概率。此外，研究表明降低辐射剂量可显著影响急性副作用的NTCP，其影响程度取决于NHL的侵袭性。本研究为前瞻性评估当前NHL治疗中降低放疗剂量后不良反应发生概率提供了基础依据。
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