优化在线适应时间在治疗局部晚期宫癌的治疗
Allen Yen1, Xinran Zhong1, Mu-Han Lin1
1Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.
Practical radiation oncology
|November 3, 2023
概括
对于宫癌,每周或每两周一次的在线自适应性放射治疗 (ART) 与传统的图像导向放射治疗 (IGRT) 相比,提供了更好的风险器官 (OAR) 节省. 这种方法平衡了资源可行性与通过适应解剖变化的有效治疗.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 妇科瘤学 妇科瘤学
背景情况:
- 在线适应性辐射疗法 (ART) 是一种用于宫癌的新型治疗方法,与传统的图像引导辐射疗法 (IGRT) 相比,它具有潜在的优势.
- 每日在线ART可以提高目标覆盖率和危险器官 (OAR) 节省,但对于繁忙的诊所来说,可能需要大量资源.
- 宫癌患者在治疗期间经历了显著的子宫体积变化,这表明较少的适应仍然可能是有益的.
研究的目的:
- 为了比较不同线上适应性辐射治疗 (ART) 计划对宫癌的剂量测量结果.
- 与日常适应和传统IGRT相比,评估较少频繁的适应计划 (每周一次,每两周一次,一次适应) 的可行性.
主要方法:
- 对每天在线ART治疗的10名宫癌患者进行了回顾性分析.
- 对每周,每两周,一次适应和没有适应 (IGRT) 计划的剂量计计划进行了模拟.
- 配对t测试用于比较模拟计划中的剂量测量,使用来自日常自适应工作流程的合成CT图像.
主要成果:
- 每周和两周一次的ART计划显示了与IGRT相似的临床目标体积 (CTV) 覆盖范围,但显著改善了OAR节省.
- 与IGRT相比,每周和两周一次的ART观察到肠囊V40,膀V40,直肠V40和骨髓Dmean的显著减少.
- 与IGRT相比,单一的适应计划显示目标覆盖率较差,只有适度的OAR节省改善.
结论:
- 与宫癌的传统IGRT相比,每周或两周一次的在线ART提供了剂量测量效益,包括减少OAR剂量.
- 这些不太频繁的适应计划有效地利用了治疗期间子宫的逐渐解剖变化.
- 适应每周或每两周一次的在线ART是资源有限的临床环境中每日适应的可行和有益的替代方案.
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