在质子疗法中优化QACT频率:对治疗地点的标准指南的分析
Rachel B Ger1, Todd R McNutt1, Curtiland Deville1
1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
International journal of particle therapy
|October 27, 2025
概括
质量保证计算机断层扫描 (QACT) 频率在质子疗法中的标准化显著减少了QACT,而不影响适应性规划. 这提高了效率和患者护理.
科学领域:
- 医学物理 医学物理
- 辐射瘤学 辐射瘤学
- 辐射疗法质量保证 辐射疗法质量保证
背景情况:
- 质子疗法利用质量保证计算机断层扫描 (QACT) 扫描来监测解剖变化.
- 过度的QACT增加了患者负担,资源利用率和医疗保健成本.
研究的目的:
- 评估在质子疗法中在各种治疗场所实施标准化最低QACT频率的影响.
- 评估标准化QACT指导方针是否会减少QACT的使用,并影响适应性规划率.
主要方法:
- 约翰霍普金斯原子疗法中心成年质子疗法患者的回顾性分析.
- 针对头部和部 (HN),胸部,骨盆,前列腺,头骨和乳房部位,制定了最低QACT频率的指导方针.
- 通过使用统计测试 (t-test,Wilcoxon签名等级测试),比较QACT使用率和适应性规划率在 (Oct 2019-Apr 2023) 和 (Aug 2023-Oct 2024) 指南实施之前使用统计测试 (t-test,Wilcoxon签名等级测试).
主要成果:
- 总共有681名患者在指导方针之前和381名患者在指导方针之后被分析.
- 总体而言,QACT频率显著下降 (中位数为3到2,P<.0001),以及头骨,HN和骨盆前列腺部位.
- 适应性治疗率在统计学上保持不变 (P = .22),表明降低的QACT并没有影响治疗适应性的识别.
结论:
- 建立标准的最低QACT频率显著减少了在多个治疗地点进行的QACT.
- 这些发现支持使用结构化QACT指南来提高资源效率并减少质子治疗中的患者负担.
- 圆束计算机断层扫描 (CBCT) 在检测需要适应性重新规划的解剖变化方面被证明是有效的.
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