利用高保真模式改善在线自适应式立体感加速部分乳房治疗效率
Joel A Pogue1, Jingwei Duan1,2, Joseph Harms1,3
1Department of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Advances in radiation oncology
|February 4, 2026
概括
在Ethos v2.0中的高保真 (HF) 模式显著减少了在线自适应性辐射疗法 (OART) 优化时间,以超过50%的立体加速部分乳房照射 (APBI),提高治疗效率,同时保持计划质量.
科学领域:
- 医学物理 医学物理
- 辐射瘤学 辐射瘤学
- 放射治疗技术 放射治疗技术
背景情况:
- 在线适应性辐射疗法 (OART) 使用形束计算断层扫描 (CBCT) 用于立体加速部分乳房照射 (APBI) 解决乳房切除术床变异.
- 然而,OART的每日再优化会延长治疗时间,可能会增加患者的不适和骨折内变化.
研究的目的:
- 调查使用高保真度 (HF) 模式在APBI OART的立体辐射疗法的可行性.
- 通过in silico研究分析高频模式对优化时间和计划质量的影响.
主要方法:
- 一项追溯的in silico研究分析了25个患者数据集,其中10个用于调整HF规划策略.
- 用虚拟规划软件模拟了15名患者的5个OART分数,并比较了高频和非高频模板.
- 分析了剂量-体积组图指标,优化时间和质量保证结果.
主要成果:
- 与非HF相比,HF适应性规划显示乳房V100%/50%和肋骨D0.01cc的轻微改善,PTVV100%和肺V30%略低于非HF.
- 平均在线优化时间在高频模式下每小部分减少了54% (5.4分钟).
- 患者特异性质量保证在分娩准确度上没有显著差异 (两者的gamma通过率>97%).
结论:
- 利用Ethos v2.0 HF模式可以显著提高体积调制弧线治疗APBI的治疗效率.
- 优化时间减少了50%以上,在非临床环境中保持了计划质量.
- 这种方法可以减少患者的不适,并减轻APBI OART中的断层内变化.
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