减少局部晚期左侧乳腺癌的螺旋TomoTherapy中低剂量暴露,使用可变形图像注册的剂量模拟工作流
Chih-Chieh Chang1,2,3, Jo-Ting Tsai1,4,5, Shih-Ming Hsu2,3
1Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan, ROC.
Journal of applied clinical medical physics
|January 27, 2026
概括
使用完整块的新可变形图像注册 (DIR) 工作流显著减少了螺旋TomoTherapy中的低剂量暴露和积分剂量. 在Radixact平台上的这种个性化规划方法可以提高效率,而不会影响患者的安全.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 图像指导疗法是指导图像的疗法.
背景情况:
- 螺旋式TomoTherapy提供符合乳房照射,但遭受显著的低剂量泄漏,增加整体剂量和潜在的长期毒性.
- 完全阻断可以减轻低剂量传播,但在较旧的TomoTherapy系统上,历史上增加了治疗时间.
研究的目的:
- 开发和验证基于可变形图像注册 (DIR) 的工作流程,用于预测患者特定的低剂量分布.
- 为TomoTherapy生成个性化的完整块,以减少低剂量暴露和整体剂量.
- 评估 Radixact 平台是否可以减少治疗时间,同时保持剂量测量效益.
主要方法:
- 对28名患者的回顾性分析 (18 t-VMAT, 10 TomoTherapy).
- 从t-VMAT图谱中基于DIR的剂量预测,以创建Hi-Art (TOMO_RE) 和Radixact (TOMO_FA) 重新规划的完整块.
- 对剂量计终点的评估,包括目标符合性,均性,OAR剂量和整数剂量 (ID).
主要成果:
- 与TOMO_ORI相比,TOMO_FA显著降低了对侧肺平均剂量和心脏V5.
- 在TOMO_FA.使用时,观察到身体-PTV积分剂量的显著下降.
- 高剂量的心脏参数仍然可以接受,而Radixact显示治疗时间大大缩短.
结论:
- 基于DIR的完整块工作流程有效地将螺旋式TomoTherapy中的低剂量暴露和积分剂量最小化.
- 在Radixact平台上的实施保持了交付效率,提供了一个实用,个性化的规划解决方案.
- 这种方法对于需要严格低剂量节约治疗的患者来说尤其有益.
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