九年的宫癌日程计划:与完全在线的适应性技术相比,计划库仍然有效
Dominique Reijtenbagh1, Jérémy Godart1, Joan Penninkhof1
1Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
概括
宫癌放射治疗的"一天计划" (PotD) 策略有效地节省了正常组织,而没有适应. 完全在线适应技术提供了进一步的节约,但PotD仍然是一个切实可行的替代方案.
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:
- 宫癌放射治疗通常使用外部光束辐射.
- 自2011年以来,以图书馆为基础的"一天计划" (PotD) 策略已被采用,以减少正常组织剂量.
- 在线适应性重新规划为进一步降低剂量提供了潜力.
研究的目的:
- 为了比较当前PotD策略的表现与非适应性和完全在线适应性技术.
- 为了评估不同放射治疗策略的目标体积覆盖率和正常组织节省.
- 评估剂量减少在计划图书馆方法和完全在线适应性技术之间的关系.
主要方法:
- 对376名使用PotD协议治疗的宫癌患者的回顾性分析 (2011年6月 - 2020年4月).
- 为三个策略重建规划目标量 (PTV):完全在线调整,没有调整,以及最新的PotD协议.
- 通过分析PTV边缘体积和PTV与膀和直肠的重叠来估计正常组织的节省.
主要成果:
- 与没有调整相比,PotD方法减少了PTV利额度的中位数为250 cm3.
- 膀-PTV和直肠-PTV重叠显著减少了PotD (中位数分别为71厘米3和16厘米3) 与没有适应 (142厘米3和39厘米3) 相比.
- 完全在线适应技术进一步减少了PTV体积和器官重叠,但具有更复杂的工作流.
结论:
- 当前的PotD协议有效地改善了与非适应性方法相比,在宫癌放射治疗中节省正常组织.
- 完全在线适应技术提供额外的节约,但可能与工作流程复杂性相比影响有限.
- PotD类型的协议是对子宫癌治疗的完全在线适应性方法的可行和实用的替代方案.
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