优化乳房和胸壁治疗计划:在VMAT放射治疗中集成动态聚合器旋转与静态角度调节端口
Emily Hubley1, Yin Gao1, Brandon Koger1
1Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Journal of applied clinical medical physics
|February 9, 2026
概括
优化乳房和胸壁治疗的RapidArc动态 (RAD) 涉及使用两个静态角度调制端口 (STAMP) 和"在静态角度之间进行优化"的动态聚合器设置,以获得卓越的剂量测量结果.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 癌症治疗计划 癌症治疗计划
背景情况:
- 快速弧动态 (RAD) 结合了静态角度调制端口 (STAMP) 与动态协同器进行弧交付.
- 对于RAD的最佳参数,包括STAMP数量,对比器使用和弧/STAMP权重,需要对乳房和胸壁治疗进行调查.
研究的目的:
- 确定RAD参数的最佳配置,用于计划乳房和胸壁治疗.
- 通过优化STAMP数量,动态对比器设置和弧/STAMP权重来实现卓越的剂量测量结果.
主要方法:
- 13名乳房和胸壁患者使用RAD进行了治疗计划.
- 用三个动态聚合器选项,五个弧形/STAMP权重方案,以及2,4或6个STAMP,结合自动皮肤闪光,生成了计划.
- 将RAD计划与使用DVH指标和MU的传统RapidArc (RA) 计划进行了比较,并通过对T测试 (p ≤0.05) 进行统计分析.
主要成果:
- 动态聚合器的"在静态角度之间优化"设置产生了最好的结果.
- 将STAMP从2增加到4或6在某些情况下改善了PTV V105%,但提供了有限的一般益处.
- 与平衡权重相比,弧主导权重导致DVH指标明显差;在平衡,静态或静态主导权重方案之间观察到最小的剂量差异.
结论:
- 乳房和胸壁RAD计划的推起始参数包括2个STAMP (类似于乳房触点),"在静态角度之间进行优化"的动态对比器设置,以及平衡,静态或静态主导的权重.
- 应避免弧形主导权重,因为它会导致质量最低的计划.
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