在线自适应辐射疗法:预防性参考规划审查方法中的风险缓解
Mahbubur Rahman1, Zohaib Iqbal1, David Parsons1
1Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas.
Advances in radiation oncology
|October 14, 2024
概括
一个新的参考计划检查清单通过提高计划质量和在患者治疗之前检测潜在的失败,显著降低了在线自适应性放射治疗 (oART) 的风险.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 质量管理质量管理.
背景情况:
- 在线适应性辐射疗法 (oART) 需要强大的计划来管理时间变化和独特的风险.
- 评估参考计划的可靠性对于预测治疗期间的变化和预防缺陷至关重要.
研究的目的:
- 为了进行形束计算机断层扫描 (CBCT) 引导的自适应工作流程的风险分析.
- 评估适应特异性参考规划审查,以减轻风险和防止治疗缺陷.
主要方法:
- 质量管理团队进行了故障树分析和故障模式和影响分析.
- 风险优先级号码 (RPNs) 用和没有参考规划检查清单来计算.
- 根源原因分析调查了一个特定的适应计划生成失败.
主要成果:
- 参考规划检查清单将故障模式从29个减少到1个 (RPN>150),包括14个适应性特定问题.
- 检查清单解决了目标剂量和治疗缺陷中的错误,提高了计划的质量和稳定性.
- 确定了轮,规划,设置,调度和文档错误,70个中的29个是适应性特定的.
结论:
- 参考规划检查清单可以更好地检测oART中的故障模式.
- 实施检查清单可以提高计划的质量和稳定性,防止治疗延迟.
- 检查清单可以适应特定的诊所需求,并且可以在各个规划阶段进行整合.
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