应用光子衍生的最坏情况稳定性标准来规划质子疗法
Krishmita Siwakoti1, Allison P Dalton2, Jared A Maas2
1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
International journal of particle therapy
|March 10, 2025
概括
质子束疗法 (PBT) 前列腺计划比强度调节辐射疗法 (IMRT) 基准不那么强大. 修改PBT计划以满足这些稳定性标准对有风险的器官的影响最小,建议采用PBT计划.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 强度评估对于质子束疗法 (PBT) 规划至关重要.
- 目前的PBT稳定性标准尚未明确,这阻碍了最佳的治疗计划.
研究的目的:
- 将PBT计划的稳定性与已建立的强度调节放射治疗 (IMRT) 衍生临床目标体积 (CTV) 基准进行比较.
- 评估当PBT计划被修改以满足IMRT衍生可靠性基准时对处于风险的器官 (OAR) 的剂量计影响.
主要方法:
- 评估了前列腺癌患者的PBT计划 (70 GyE分为28个小部分).
- 在CTV V100%,CTV V95%,直肠V70 Gy和膀V60 Gy的标称和最坏情况下评估计划的稳定性.
- 修改了PBT计划 ("基准"计划) 以满足IMRT衍生的最坏情况下的CTV基准,并将剂量与"临床"计划进行比较.
主要成果:
- 只有31%的临床PBT计划达到IMRT衍生的最坏情况下的CTV基准 (CTV V100%>90%和CTV V95%>99%).
- 所有修改后的基准计划都达到最坏情况下的CTV值.
- 基准计划显示,名义直肠V70 Gy (0.72至0.92厘米3) 和膀V60 Gy (5.9%至6.0%) 略有增加,整体计划热点 (104.5%至105.5%) 显著增加.
结论:
- 与IMRT衍生基准相比,临床PBT计划的稳定性较低.
- 修改PBT计划以达到这些基准是可行的,对OAR剂量测量具有有限的,临床上可接受的影响.
- 建议采用IMRT衍生的稳健性标准来规划前列腺PBT.
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