开发和临床应用的概率稳定性评估工具,用于笔束扫描质子疗法治疗
Francesco Fracchiolla1, Lamberto Widesott1, Roberto Righetto1
1U.O. Fisica Sanitaria Trento Hospital APSS Proton Therapy Department Trento Italy.
概括
为质子疗法开发了一种新的概率强度评估 (pRE) 工具. 它准确评估治疗不确定性,优于最坏情况方法 (wRE),现在在临床上使用.
科学领域:
- 医学物理 医学物理
- 辐射瘤学 辐射瘤学
- 质子疗法是一种治疗方法.
背景情况:
- 质子疗法规划需要对不确定性的强有力的评估.
- 当前的商业处理计划系统 (TPS) 经常使用最坏情况方法 (wRE) 来进行稳定性评估.
- 需要对治疗不确定性的更现实和明确的评估.
研究的目的:
- 为质子疗法实施一个概率-坚固性-评估 (pRE) 工具.
- 将pRE结果与临床最坏情况方法 (wRE) 进行比较.
- 为了将pRE发现与TPS的既定临床实践相关联.
主要方法:
- 开发了一个包含光束传递,患者定位和范围不确定性的pRE工具.
- 分析了10年的机器质量保证 (QA) 数据和后处理成像.
- 模拟了各种不确定性组合的wRE,并将结果与目标覆盖率和OAR剂量限制的pRE进行了比较.
主要成果:
- 分析了43,400个剂量分布;预备剂量模拟平均为18.6小时.
- 确定了wRE参数 (1.0mm/3.5%),以95%的保证率最好地近似pRE结果.
- 观察到OARs (1.90 GyRBE) 和目标 (-0.66至-0.67 GyRBE) 的pRE和wRE之间的中位数剂量差异.
结论:
- 实施了一种新的pRE工具,用于对现实的质子疗法计划的稳定性评估.
- 该工具明确模拟不确定性和分成效.
- 优化了wRE参数,以在临床时间限制内匹配pRE结果,现在集成到临床工作流程中.
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