针对头癌的剂量计触发适应性放射治疗:对实施临床方案的考虑
Ana M Barragán-Montero1, Geneviève Van Ooteghem1,2, Damien Dumont1,2
1UCLouvain, Center of Molecular Imaging, Radiotherapy and Oncology (MIRO), Brussels, Belgium.
Journal of applied clinical medical physics
|July 14, 2023
概括
这项研究开发了一种自动自适应性放射治疗 (ART) 协议,用于使用剂量计规则治疗头癌. 升级后的协议准确地识别了需要ART的患者,减少了不必要的干预.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 在瘤学瘤学.
背景情况:
- 适应性放射治疗 (ART) 协议用于头癌 (H&N) 往往是临时性的.
- 根据剂量计规则自动检测需要ART的患者是具有挑战性的.
研究的目的:
- 设计和分析一个对H&N癌症的剂量计触发ART的协议.
- 通过每日MVCT成像和TomoTherapy单元的剂量累积来验证该协议.
主要方法:
- 一个代的协议设计,涉及一个多学科的团队和剂量-体积指标.
- 适用于38名H&N患者,每天进行轮和剂量重新计算.
- 通过敏感性/特异性分析,将自动标记与医生决策进行比较.
主要成果:
- 最初的协议灵敏度很低 (0.15为色旗).
- 升级协议的灵敏度提高到0.96 (红旗) 和0.84 (旗).
- 减少CTV-to-PTV利率使得标记率下降了18%至26%.
结论:
- 使用回顾性数据的代协议设计对于创建自动化ART协议非常有价值.
- 简单的剂量计规则可以有效地模仿医生对ART触发的决定.
- 目标量定义显著影响ART协议中的标记率.
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