在线适应磁共振导向前列腺辐射疗法的比较
Iymad R Mansour1,2, Chris D Johnstone1,2, Victor Malkov1,2
1Radiation Medicine Program, Princess Margaret Cancer Centre, Ontario, Canada.
Physics and imaging in radiation oncology
|August 21, 2025
概括
使用适应位置 (ATP) 和适应形状 (ATS) 策略的MR导向适应性辐射疗法显示前列腺癌患者的目标覆盖率相当. 虽然观察到有风险的小器官差异,但它们仍在临床容忍范围内.
科学领域:
- 医学物理
- 辐射瘤学
- 放射治疗技术
背景情况:
- 用MR指导的适应性辐射疗法使每日计划可以根据解剖变化进行调整.
- 适应位置 (ATP) 和适应形状 (ATS) 是两个主要的适应策略.
- 本研究使用前列腺癌患者的累积剂量来比较ATP和ATS的剂量结果.
研究的目的:
- 在MR导向的适应性放射治疗中进行ATP和ATS策略的剂量比较.
- 评估每日解剖学变化对治疗计划的影响.
- 评估ATP和ATS之间的剂量差异的临床意义.
主要方法:
- 在接受1.5T MR-Linac治疗的35名前列腺癌患者中进行了剂量积累.
- 提供基于ATS的治疗,并追溯模拟ATP计划.
- 使用可变形图像记录将分量剂量映射到参考图像以进行总和.
主要成果:
- 在两种治疗方案中,ATP和ATS均获得了可比的累积CTV D95和D98.
- 在特定群体的风险器官剂量 (膀,直肠,股骨) 中发现了统计学上显著但临床上最小的差异.
- 两种策略之间的剂量变化与间断运动相关.
结论:
- 在前列腺癌的MR导向适应性放射治疗中,ATP和ATS的目标覆盖率相当.
- 在ATP和ATS之间观察到的风险器官剂量差异具有统计学意义,但在临床上可接受的范围内.
- 这些发现表明ATP和ATS策略之间的剂量变化对临床的影响很小.
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