基于CT的适应性放射治疗对腹部治疗的经验和不确定性分析
J V Panetta1, A Eldib1, J E Meyer1
1Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
概括
在线适应性放射治疗 (ART) 通过允许日常计划调整来改善腹部癌症的治疗. 这项研究证明了ART的存在.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 在线适应性放射治疗 (ART) 能够根据实时解剖变化进行日常重新规划.
- 腹部病例对放射治疗具有独特的挑战,原因是器官运动和关键结构的接近.
研究的目的:
- 在腹部病例中提出基于CT的ART的方法.
- 报告与这种自适应方法相关的临床经验和不确定性.
- 评估ART对治疗计划质量的影响.
主要方法:
- 分析了41名患有腹部点 (胰腺,肝脏,淋巴结) 的患者 (205个分数),这些患者接受了基于CT的ART治疗.
- 评估轮时间,规划目标体积 (PTV) 覆盖范围,以及危险器官 (OAR) 节省.
- 从轮变化和自动记录转移中估计不确定性.
主要成果:
- 与计划计划 (92.0%) 相比,适应性计划实现了更高的PTV覆盖率 (94.7%).
- 治疗ART导致OAR最大剂量平均下降11.6%.
- 在PTV覆盖率的不确定性很低 (0.6%),和联合OAR剂量不确定性是4.6%.
结论:
- 在腹部病例中,基于CT的ART可以改善PTV覆盖率和节省OAR.
- 既定的工作流程有助于在实际的时间框架内完成治疗.
- 适应性治疗的好处明显超过估计的不确定性.
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