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在线适应性H&N IMPT与计划库方法的自动目标划定 - 可行性研究

M K Giżyńska¹, M Oud², S Breedveld³

¹Holland Proton Therapy Center, Department of Medical Physics & Informatics, Delft, The Netherlands.

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)

|October 24, 2025

概括

商业上可用的自动轮方法显示了基于计划库的在线自适应强度调制质子治疗在头癌中的可行性,确保了足够的患者剂量,对目标覆盖和正常组织并发症概率的影响最小.

科学领域:

医学物理医学物理
辐射瘤学辐射瘤学
计算生物学计算生物学

背景情况:

基于PL的在线自适应强度调制质子疗法 (IMPT) 是一种新的头癌治疗方法.
这种方法涉及预先生成具有不同设置稳定性 (SR) 设置的强有力的治疗计划.
每天选择基于重复CT (rCT) 目标覆盖率的计划,需要快速而精确的自动化目标划分用于临床使用.

研究的目的:

评估使用商用自动轮方法在线适应性IMPT在HN癌症中的可行性.
评估自动轮对计划选择,目标覆盖和正常组织并发症概率 (NTCP) 的影响.

主要方法:

在15名HN患者和67个RCT中测试了19种自动轮方法,与手动生成的地面真相 (GT) 轮 (CTV7000和CTV5425) 进行比较.
评估的指标包括轮精度,选定的计划,实现目标覆盖率 (V95%) 和预测的NTCP.
绩效是根据计划选择与GT的一致性和对剂量覆盖的影响来评估的.

主要成果:

五种最有效的自动轮方法实现了66-72%的平面选择协议与GT轮.
在19-26%的案例中,选择了具有更高SR的计划,保持了目标覆盖率.
对于CTV7000,近最低V95%的高 (96.9%/>97.6%),只有一个患者的覆盖率降低.
自动轮导致NTCP小幅增加,明显低于在线与离线自适应IMPT的改善.

结论:

商用可选的自动轮工具通常适合基于PL的在线自适应性IMPT在HN癌症中.
这些方法确保了可接受的患者剂量测量,对治疗疗效的妥协最小.
自动轮方便了先进的适应性质子疗法技术的临床实施.

关键词:

自动轮自动轮每天在线适应性放射治疗使用计划图书馆.这是头癌.强度调节质子疗法 (IMPT) 是一种强度调节质子疗法.

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