适应性IMPT与适应性IMPT的剂量测量优势 增加工作量和处理时间 - - 需要自动化
Michelle Oud1, Sebastiaan Breedveld2, Marta Giżyńska3
1Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Radiotherapy, Rotterdam, Netherlands; HollandPTC, Delft, Netherlands.
概括
头强度调节质子疗法 (IMPT) 的新在线适应策略与完全重新规划的剂量度质量相匹配. 这种方法虽然增加了工作量,但与当前的离线方法相比,可以显著降低治疗毒性.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 癌症治疗方法 癌症治疗方法
背景情况:
- 针对头癌的强度调节质子疗法 (IMPT) 通常使用基于触发器的离线计划适应.
- 评估替代适应性策略对于优化剂量测量,工作量和治疗时间至关重要.
研究的目的:
- 为了比较线下基于触发的适应与四种替代的适应策略在头部和部IMPT.
- 评估这些策略对剂量计质量,患者毒性,工作量和治疗时间的影响,并考虑未来的自动化.
主要方法:
- 使用重复CTs对15名患者进行模拟,每周评估离线重新规划,基于图书馆的静态和渐进的选择,以及快速的每日在线重新优化 (在线re-opt).
- 剂量测量结果 (CTV覆盖率,NTCPs) 和估计的工作量和治疗时间的增加与全日重新规划基准进行了比较.
主要成果:
- 在线re-opt策略实现了与完全重新规划可比的剂量测量质量,优于当前离线方法.
- 在线re-opt显示了更高的覆盖概率和显著的降低等级≥II Xerostomia (4.6%) 和食障碍 (4.2%).
- 离线和图书馆策略显示出有限的剂量测量改进,而自动化是通过先进的自适应方法来管理增加的工作量和治疗时间的关键.
结论:
- 在线适应性策略可以在头部和部IMPT中实现高剂量质量,接近完全重新规划的质量.
- 这些先进的策略可能会增加工作量和治疗时间,但可以大幅减少患者的毒性.
- 进一步的自动化对于使复杂的自适应性质子疗法方法在临床上可行和有效至关重要.
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