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对输送和计划剂量的目标体积进行比较分析,用于肺部立体性废除性放射治疗

Geum Bong Yu^1,2, Jung In Kim^1,2,3, Hak Jae Kim^1,4,5

¹Department of Radiation Oncology, Seoul National University Hospital, 101, Daehak-ro, Jongno- gu, Seoul, 03080, Republic of Korea.

Radiation oncology (London, England)

|August 16, 2024

概括

适应式计算机断层扫描 (ACT) 在肺癌放射治疗中准确地将处方剂量传递到内部目标体积. 然而,与图像注册参数相关的,观察到输送剂量与计划目标体积 (PTV) 的变化.

科学领域:

辐射瘤学辐射瘤学
医疗成像医学成像
癌症治疗癌症治疗

背景情况:

放射治疗中的自适应疗法已经在自适应计算机断层扫描 (ACT) 生成从计划CT (PCT) 和车载成像方面取得了进展.
这项研究利用ACT评估非小细胞肺癌 (NSCLC) 患者接受立体性废除性放射治疗 (SABR) 的输送辐射剂量.

研究的目的:

为了评估与SABR治疗的NSCLC患者的输送辐射剂量.
为了建立交付剂量和从ACT评估中得出的参数之间的关系.

主要方法:

对72名用SABR治疗的NSCLC患者的回顾性分析 (60Gy分4个小部分).
通过PCT到形光束CT (CBCT) 的刚性和可变形注册生成288个ACT.
使用多重线性回归和ANOVA分析几何 (Warp_mean,DSC) 和剂量计 (ΔHI,D_mean) 参数.

主要成果:

处方剂量在1%的差异范围内准确地传递到内部目标体积 (ITV).
在超过95%的ACT病例中,计划和输送剂量之间的PTV剂量差异在6%以内.
在PTV参数 (Warp_mean, DSC, ΔHI, D_mean) 和交付的PTV D95%之间发现了显著的相关性,较高的ΔHI与较低的交付PTV D95%相关.

结论:

在NSCLC SABR.中,ACT证实了对ITV的准确剂量输送.
在某些ACT病例中,同质性指数 (HI) 与原始计划的偏差表明输送剂量对PTV的变化.
在治疗期间患者设置的变化可能导致观察到的剂量差异.

关键词:

适应性CTCT可以适应.可变形图像的注册方式剂量评估剂量评估肺部SABR 肺部SABR 肺部SABR 肺部SABR 肺部SABR 肺部SABR 肺部SABR

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