在前列腺癌患者中管理不一致的膀体积,使用每日在线自适应RT:病例报告
Venkada Manickam Gurusamy1, Yoganathan Sullimullur Arunachalam1, Mohamed Riyaz Poolakundan1
1Department of Radiation Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar.
The Gulf journal of oncology
|May 22, 2024
概括
在线适应性放射治疗 (OART) 在前列腺癌患者中有效地管理了不一致的膀体积. 与标准的图像引导RT相比,这种方法改善了目标覆盖率和膀节省率.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 前列腺癌的治疗通常涉及放射治疗.
- 图像引导RT (IGRT) 是标准的,但患者解剖学的变化可能会影响结果.
- 在线适应性放射治疗 (OART) 提供实时计划调整.
研究的目的:
- 评估OART在前列腺癌患者中具有不一致的膀填充的可行性和剂量效益.
- 将OART与标准IGRT进行目标覆盖和危险器官节省的比较.
主要方法:
- 使用Ethos治疗计划系统进行了OART.
- 高质量的形光束CT (CBCT) 图像引导日常计划的调整.
- 将适应性计划与重新计算的IGRT计划进行了比较.
主要成果:
- 与IGRT相比,OART的计划目标体积 (PTV 70 Gy) 覆盖率高于IGRT (97.3%对比90.5%).
- 膀接受的高剂量OART辐射显著减少 (V65 Gy:14.8%对比17.9%).
- 在OART和IGRT之间,直肠剂量 (V65 Gy) 类似.
结论:
- 以CBCT为指导的ORT是一种可行的方法,用于管理像前列腺癌放射治疗中的膀体积不一致等解剖变异.
- 与在线IGRT相比,OART提供了更好的目标覆盖和膀节省.
- 这种适应性策略提高了无法遵守标准方案的患者的治疗精度.
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