- 作者：Javier Pascau ; Ph.D.&lowast ; ; § ; ; jpascau@mce.hggm.es ; Juan Antonio Santos Miranda ; M.D. ; Ph.D.&dagger ; ; ¶ ; ; Felipe A. Calvo ; M.D. ; Ph.D.&dagger ; ; ¶ ; ; &Dagger ; ; Ana Bouché ; M.D.鈥?/sup> ; Virgina Morillo ; M.D.鈥?/sup> ; Carmen Gonzá ; lez-San Segundo ; M.D. ; Ph.D.&dagger ; ; ¶ ; ; Carlos Ferrer ; M.D. ; Ph.D.鈥?/sup> ; Juan Ló ; pez Tarjuelo ; M.Sc.鈥?/sup> ; Manuel Desco ; M.D. ; Ph.D.&lowast ; ; § ;
- 关键词：Intraoperative electron beam radiation therapy ; Intraoperative radiotherapy ; Treatment planning ; Treatment simulation ; Electrons
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：1 June, 2012
- 卷：83
- 期：2
- 页码：e287-e295
- 文件大小：1657 K
Purpose
Intraoperative electron beam radiation therapy (IOERT) involves a modified strategy of conventional radiation therapy and surgery. The lack of specific planning tools limits the spread of this technique. The purpose of the present study is to describe a new simulation and planning tool and its initial evaluation by clinical users.Methods and Materials
The tool works on a preoperative computed tomography scan. A physician contours regions to be treated and protected and simulates applicator positioning, calculating isodoses and the corresponding dose-volume histograms depending on the selected electron energy. Three radiation oncologists evaluated data from 15 IOERT patients, including different tumor locations. Segmentation masks, applicator positions, and treatment parameters were compared.
Results
High parameter agreement was found in the following cases: three breast and three rectal cancer, retroperitoneal sarcoma, and rectal and ovary monotopic recurrences. All radiation oncologists performed similar segmentations of tumors and high-risk areas. The average applicator position difference was 1.2 卤 0.95 cm. The remaining cancer sites showed higher deviations because of differences in the criteria for segmenting high-risk areas (one rectal, one pancreas) and different surgical access simulated (two rectal, one Ewing sarcoma).
Conclusions
The results show that this new tool can be used to simulate IOERT cases involving different anatomic locations, and that preplanning has to be carried out with specialized surgical input.