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Nathan Torelli¹, Jan Unkelbach¹

¹Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Medical physics

|April 17, 2025

概括

时空分离 (STF) 在每个治疗分数中使用不同的辐射剂量. 在STF中,新的非共平面光束角度显著降低了肝转移和大脑动脉静脉形缺陷的正常组织的辐射剂量.

科学领域:

辐射瘤学辐射瘤学
医学物理医学物理

背景情况:

时空分化 (STF) 旨在为瘤提供部分低分化,同时确保周围正常组织的均分化.
这种技术涉及在多个分数中分别分配剂量,以高剂量向补充性瘤区域,并节省正常组织.

研究的目的:

扩展STF方案,将每个分数的非共平面光束方向纳入其中.
调查STF中各种光束角度对治疗不同目标体积区域的潜在好处.

主要方法:

开发了一种新的基于生物有效剂量 (BED) 的直接光圈优化 (DAO) 算法,用于STF治疗.
优化了多重剂量分布,多片叠加孔口,并同时监测每个分量的单位重量.
实现了特定于分数的非共平面动态轨迹,具有360°门架弧和动态沙发旋转.
展示了使用立体性身体放射疗法 (SBRT) 治疗肝转移和用立体性放射疗法 (SRT) 治疗动脉静脉形 (AVM) 的方法.

主要成果:

STF治疗实现了高度不均的剂量分配,适合特定的分数.
与共平面VMAT相比,分量特定的非共平面轨迹导致平均肝脏BED3 (13.7%) 和大脑BED2 (18.4%) 的显著减少.
在肝转移和AVM病例中观察到这些改善,保持了目标覆盖范围.

结论:

在每个分数中选择不同的非共平面光束方向可以提高STF治疗的剂量测量质量.
这种方法为在目标体积内治疗特定区域提供了显著的优势,改善了治疗比率.

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