适应强度调制质子疗法使用4D稳健规划:用于应用剂量模拟方法的概念验证
Suryakant Kaushik1,2,3, Kristin Stützer4,5, Jakob Ödén1
1RaySearch Laboratories AB (Publ), Stockholm, Sweden.
Physics in medicine and biology
|August 30, 2024
概括
使用剂量模拟的自动自适应计划改善了质子治疗的四维强大优化 (4DRO) 的目标覆盖率和器官节省,优于基于模板的方法.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 计算生物学 计算生物学
背景情况:
- 四维强大的优化 (4DRO) 对于在放射治疗中解决呼吸运动至关重要.
- 目前的4DRO方法是计算密集型的,需要手动调整,阻碍了适应性规划.
- 需要自动自适应计划来提高放射治疗的效率和准确性.
研究的目的:
- 为自动化4DRO.提出和评估一种基于剂量模拟的新型自适应 (MA) 规划技术.
- 将MA规划与基于模板的自适应 (TA) 规划的性能进行比较.
- 评估可变相对生物有效性 (vRBE) 对剂量积累的影响.
主要方法:
- 使用4DRO为患有肺,食道或胰腺瘤的患者创建了强度调节质子疗法计划.
- 两种适应性规划方法进行了比较:基于模板的适应性 (TA) 和基于剂量模拟的适应性 (MA).
- 使用生物一致剂量积累 (BCDA) 和vRBE加权剂量来评估计划.
主要成果:
- 与TA计划相比,MA计划的临床目标体积 (CTV) 覆盖率相当或优于TA计划.
- MA计划实现了更好的风险器官 (OAR) 剂量节约,降低了平均和D2剂量.
- 非适应性计划中的剂量偏差是显著的,突显了适应性策略的必要性.
结论:
- 基于剂量模拟的自适应规划是质子疗法中4DRO的一个有希望的自动化方法.
- 与TA规划相比,MA规划提供了更好的目标覆盖和OAR保护.
- 该MA方法有效地处理解剖学变化,包括密度变化和OAR位置变化.
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