确定不确定性:对高剂量率前列腺骨干疗法治疗计划的强有力的评估方法,包括不确定性的结合
Andrew C Kennedy1, Michael J J Douglass2,3,4, Alexandre M C Santos2,3,4
1School of Physical Sciences, University of Adelaide, Adelaide, SA, 5005, Australia. andrew.kennedy@adelaide.edu.au.
Physical and engineering sciences in medicine
|May 30, 2023
概括
高剂量率 (HDR) 前列腺支臂治疗的新强有力的评估方法解决了治疗的不确定性. 这种方法评估了潜在的剂量偏差,提高了危险关键结构和器官治疗计划的可靠性.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 放射治疗规划 放射治疗规划
背景情况:
- 高剂量率 (HDR) 前列腺支架治疗中的治疗不确定性可能导致偏离计划的剂量分配.
- 当前的计划评估方法往往无法考虑这些不确定性的综合影响.
- 这可能会导致关键结构的剂量计错误,并导致危险器官的过量服用.
研究的目的:
- 提出并展示一个强大的评估方法,用于评估HDR前列腺基治疗计划评估的综合不确定性.
- 量化不确定性对剂量分配和临床目标的潜在影响.
主要方法:
- 对一个HDR前列腺超声波治疗计划进行了回顾性分析.
- 改变了六个关键参数,以模拟一系列不确定性场景.
- 使用了两种模拟方法:随机抽样的概率方法和最坏情况情景分析.
- 运行了1000个概率场景,以评估剂量分布的变化.
主要成果:
- 在概率性情景中,43.2%的人实现了八个临床目标中的七个.
- 前列腺D90显示标准偏差为4.4%,最坏情况下的剂量减少高达27.2%.
- 尿道D10在最坏的情况下增加了高达29.3%.
- 概率性DVH指标在可接受的临床约束范围内.
结论:
- 开发的强有力的评估方法提供了一个全面的评估不确定性在HDR前列腺支架疗法规划.
- 该方法可以识别标准评估技术无法捕捉的潜在剂量测量风险.
- 为了确定临床意义和接受标准,需要与患者历史结果数据进行进一步验证.
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