ArcCheck剂量验证角度分析食管上段癌调强放疗技术
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摘要
目的从剂量验证角度比较食管上段癌静态调强(sIMRT)、动态调强(dIMRT)、容积旋转调强(VMAT)三种方式放射治疗技术。方法选取2017年1月到2017年12月在淮安市第一人民医院接受治疗的20例食管上段癌患者资料,按处方要求每位患者在Monaco治疗计划系统分别设计3个不同调强技术的计划,然后将设计完成的计划传输到MOSAIQ系统上,同时将治疗计划均植入到ArcCheck模体上重新计算剂量。对治疗计划系统中计算的结果与实际测量的结果进行对比分析,阈值标准选择3%,3 mm,10%。结果这三种调强技术Gamma相对剂量和绝对剂量通过率均满足临床要求。sIMRT的通过率相对较高,相对于dIMRT和VMAT有明显的优势,dIMRT和VMAT通过率无明显差异。结论从剂量验证角度来看食管上段癌静态调强放疗计划通过率更高。
Objective To analysis the difference among three radiotherapy techniques(sIMRT, dIMRT and VMAT) for the treatment of upper esophageal cancer from the perspective of dose verification. Methods Data of 20 patients with upper esophageal cancer who received treatment in Huai′an First People′s Hospital between January 2017 and June 2017 were selected. Each patient according to the requirement is required to design three different intensity-modulated Monaca system technology plans, and then transfer the completed plans to the MOSAIQ system, at the same time the treatment plan was implanted into the ArcCheck model to recalculate the dose. Compared the results calculated in the Monaco system with the results calculated by Gamma methods. The threshold standards were 3%, 3 mm and 10%.Results The relative dosages and absolute dosage of all three modulated techniques met clinical requirements. The pass rate of sIMRT is relatively higher, which has obvious advantages over dIMRT and VMAT, and there is no significant difference between dIMRT and VMAT. In relative terms, dIMRT has more advantages.Conclusion From the perspective of dose verification, sIMRT has a higher pass rate of radiotherapy for the treatment of upper esophageal cancer.
Objective To analysis the difference among three radiotherapy techniques(sIMRT, dIMRT and VMAT) for the treatment of upper esophageal cancer from the perspective of dose verification. Methods Data of 20 patients with upper esophageal cancer who received treatment in Huai′an First People′s Hospital between January 2017 and June 2017 were selected. Each patient according to the requirement is required to design three different intensity-modulated Monaca system technology plans, and then transfer the completed plans to the MOSAIQ system, at the same time the treatment plan was implanted into the ArcCheck model to recalculate the dose. Compared the results calculated in the Monaco system with the results calculated by Gamma methods. The threshold standards were 3%, 3 mm and 10%.Results The relative dosages and absolute dosage of all three modulated techniques met clinical requirements. The pass rate of sIMRT is relatively higher, which has obvious advantages over dIMRT and VMAT, and there is no significant difference between dIMRT and VMAT. In relative terms, dIMRT has more advantages.Conclusion From the perspective of dose verification, sIMRT has a higher pass rate of radiotherapy for the treatment of upper esophageal cancer.
引文
[1] 谷铣之,殷蔚伯,余子豪.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2008,546-574.
[2] Chandra A,Guerrero T M,Liu H H,et al.Feasibility of using intensity-modulated radiotherapy to improve lung sparing in treatment planning for distal esophageal cancer [J].Radiother Oncol,2005,77 (3):247-253.
[3] Fenkell L,Kaminsky I,Breen S,et al.Dosimetric comparison of IMRT vs.3D conformal radiotherapy in the treatment of cancer of the cervical esophagus [J].Radiother Oncol ,2008 ,89 (3):287-291.
[4] Nutting C M,Bedford J L,Cosgrove V P,et al.A comparison of conformal and intensity-modulated techniques for oesophageal radiotherapy [J].Radiother Oncol,2001,61 ( 2 ):157-163.
[5] 章敏娟.调强射野的实现方式研究[D].南京:东南大学,2007,14-19.
[6] 胡逸民.肿瘤放射物理学[M].北京:原子能出版社,1999,550-559.
[7] 李军,张西志,张先稳,等.Varian 医用直线加速器 DMLC 物理参数的测量与验证[J].北京生物医学工程,2015,34(5):509-513.
[8] Yu C X.Intensity-modulated arc therapy with dynamic multi-leaf collimation:an alternative to tomotherapy [J].Phys Med Biol ,1995 ,40(9):1435-1449.
[9] 张晶,王智勇,侯宁,等.上段食管癌旋转容积调强放射治疗计划的验证分析[J].现代医学与健康研究,2018,2(6):74.
[10] 孔燕,孔栋,魏贤顶,等.调强计划验证中MatriXX电离室的角度响应修正[J].中国辐射卫生,2016,25(4):398-400,405.
[11] 李成强,李光俊,冀传仙,等.ArcCHECK 半导体探头特性及在容积调强弧形治疗剂量验证应用研究 [J].中华放射肿瘤学杂志,2013,22(3):253-257.
[12] 戴越,胡春红,李小东,等.MatriXX 两种调强放疗剂量验证方法的比较分析 [J].中华放射肿瘤学杂志,2013,22(4):312-314.
[13] 张俊俊,邱小平,李奇欣,等.ArcCheck系统在鼻咽癌容积旋转调强剂量验证中的应用[J].中国医学物理学杂志,2014,31(5):5136-5137.
[14] Chen H X,Lohr F,Fritz P,et al.Stereotactic,single-dose irradiation of lung tumors:a comparison of absolute dose and dose distribution between pencil beam and Monte Carlo algorithms based on actual patient CT scans[J].Int J Radiat Oncol Biol Phys,2010,78(3):955-963.
[15] 徐洋洋,邓磊,杨亚新,等.放射治疗外照射的蒙特卡罗计算[J].中国辐射卫生,2016,25(1):15-17.
[16] 何方方,刘主龙.蒙特卡罗技术在光子和电子放射治疗中提高速度的进展[J].中国辐射卫生,2015,24(3):314-316.
[17] Wagner D,christiansen H,Wolff H,et al.Radiotherapy of malignant gliomas:comparison of volumetric single arc technique (RapidArc),dynamic intensity-modulated technique and 3D conformal technique [J].Radiother Oncol,2009,93 (3):593-596.
[18] Clivio A,Fogliata A,Franzetti-Pellanda A,et al.Volumetric-modulated arc radiotherapy for carcinomas of the anal canal:A treatment planning comparison with fixed field IMRT [J] .Radiother Oncol,2009,92 (1):118-124.
[19] 张瑞,习勉,李巧巧,等.胸上段食管癌容积旋转调强和静态调强与三维适形放疗计划的剂量学比较[J].中山大学学报(医学科学版),2012,33(2):260-264.
[2] Chandra A,Guerrero T M,Liu H H,et al.Feasibility of using intensity-modulated radiotherapy to improve lung sparing in treatment planning for distal esophageal cancer [J].Radiother Oncol,2005,77 (3):247-253.
[3] Fenkell L,Kaminsky I,Breen S,et al.Dosimetric comparison of IMRT vs.3D conformal radiotherapy in the treatment of cancer of the cervical esophagus [J].Radiother Oncol ,2008 ,89 (3):287-291.
[4] Nutting C M,Bedford J L,Cosgrove V P,et al.A comparison of conformal and intensity-modulated techniques for oesophageal radiotherapy [J].Radiother Oncol,2001,61 ( 2 ):157-163.
[5] 章敏娟.调强射野的实现方式研究[D].南京:东南大学,2007,14-19.
[6] 胡逸民.肿瘤放射物理学[M].北京:原子能出版社,1999,550-559.
[7] 李军,张西志,张先稳,等.Varian 医用直线加速器 DMLC 物理参数的测量与验证[J].北京生物医学工程,2015,34(5):509-513.
[8] Yu C X.Intensity-modulated arc therapy with dynamic multi-leaf collimation:an alternative to tomotherapy [J].Phys Med Biol ,1995 ,40(9):1435-1449.
[9] 张晶,王智勇,侯宁,等.上段食管癌旋转容积调强放射治疗计划的验证分析[J].现代医学与健康研究,2018,2(6):74.
[10] 孔燕,孔栋,魏贤顶,等.调强计划验证中MatriXX电离室的角度响应修正[J].中国辐射卫生,2016,25(4):398-400,405.
[11] 李成强,李光俊,冀传仙,等.ArcCHECK 半导体探头特性及在容积调强弧形治疗剂量验证应用研究 [J].中华放射肿瘤学杂志,2013,22(3):253-257.
[12] 戴越,胡春红,李小东,等.MatriXX 两种调强放疗剂量验证方法的比较分析 [J].中华放射肿瘤学杂志,2013,22(4):312-314.
[13] 张俊俊,邱小平,李奇欣,等.ArcCheck系统在鼻咽癌容积旋转调强剂量验证中的应用[J].中国医学物理学杂志,2014,31(5):5136-5137.
[14] Chen H X,Lohr F,Fritz P,et al.Stereotactic,single-dose irradiation of lung tumors:a comparison of absolute dose and dose distribution between pencil beam and Monte Carlo algorithms based on actual patient CT scans[J].Int J Radiat Oncol Biol Phys,2010,78(3):955-963.
[15] 徐洋洋,邓磊,杨亚新,等.放射治疗外照射的蒙特卡罗计算[J].中国辐射卫生,2016,25(1):15-17.
[16] 何方方,刘主龙.蒙特卡罗技术在光子和电子放射治疗中提高速度的进展[J].中国辐射卫生,2015,24(3):314-316.
[17] Wagner D,christiansen H,Wolff H,et al.Radiotherapy of malignant gliomas:comparison of volumetric single arc technique (RapidArc),dynamic intensity-modulated technique and 3D conformal technique [J].Radiother Oncol,2009,93 (3):593-596.
[18] Clivio A,Fogliata A,Franzetti-Pellanda A,et al.Volumetric-modulated arc radiotherapy for carcinomas of the anal canal:A treatment planning comparison with fixed field IMRT [J] .Radiother Oncol,2009,92 (1):118-124.
[19] 张瑞,习勉,李巧巧,等.胸上段食管癌容积旋转调强和静态调强与三维适形放疗计划的剂量学比较[J].中山大学学报(医学科学版),2012,33(2):260-264.