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在头部和部癌症中,对腺的基于Dir的剂量累积:适应性放射治疗的准确性和影响

Yong Gan¹, Johannes A Langendijk², Edwin Oldehinkel²

¹University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, Groningen, the Netherlands; Shantou University, Cancer Hospital of Shantou University Medical College, Department of Radiotherapy, China.

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

|July 12, 2025

概括

对于头癌患者的剂量积累,可变形图像记录 (DIR) 可能是不准确的. 一种使用中期治疗扫描的新方法纠正了这些错误,提高了腺剂量准确度,并减少了异口腔预测错误.

科学领域:

医学物理医学物理
辐射瘤学辐射瘤学
放射治疗规划放射治疗规划

背景情况:

可变形图像注册 (DIR) 对于放射治疗中准确的剂量积累至关重要.
DIR中的错误可能会损害剂量计算的准确性,特别是对于风险的器官,如腺.
评估和纠正这些DIR诱导的错误对于优化治疗结果至关重要.

研究的目的:

评估DIR在头癌患者腺剂量积累中的准确性.
提出和验证一种方法来纠正DIR诱导的剂量累积错误.
评估纠正剂量积累对预测异口症风险的影响.

主要方法:

对123名头癌患者进行了一项回顾性研究.
腺累积平均剂量 (Dmean) 通过手动细分 (地面真相) 和两种DIR策略来确定.
正常组织并发症概率 (NTCP) 模型被用于评估基于累积的Dmean.的异口症风险.

主要成果:

在DIR和地面真相之间观察到Dmean的最大差异为4.87 Gy,NTCP的最大差异为3.94%.
累积Dmean的差异与基本事实和名义Dmean之间的差异相关.
治疗中期扫描分析纠正了DIR错误,将NTCP预测错误从2.89%和3.81%减少到1.26%和2.04%对于不同级别的异口腔.

结论:

DIR在腺剂量积累中引入了显著的差异,影响了适应性放射治疗.
使用中期处理CT扫描提供了一种实际方法来纠正DIR诱导的错误.
这种校正方法提高了剂量积累和NTCP预测的准确性,提高了放射治疗的精度.

关键词:

适应性辐射疗法适应性辐射疗法可变形图像的注册方式剂量积累剂量积累正常组织并发症概率概率.状腺是什么样子的

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