ArcCHECK摆位误差对直肠癌VMAT计划剂量验证通过率的影响
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摘要
目的探讨ArcCHECK摆位误差对直肠癌VMAT计划剂量验证通过率的影响。方法选取10例直肠癌VMAT计划,利用ArcCHECK进行计划剂量验证测量,通过在TPS上移动计划等中心的位置分别模拟Arc CHECK模体X、Y、Z方向上3、4、5 mm的摆位误差,采用绝对剂量Gamma的3%/3 mm为评价指标,分别得到每个计划的通过率。结果原计划平均通过率达到99%以上。ArcCHECK引入三个方向的摆位误差后,对直肠癌VMAT计划的剂量验证通过率均有一定程度的下降,误差越大通过率越低。引入误差后的计划与原计划的通过率相比均具有统计学意义(P<0.05)。不同方向上对通过率的影响存在差别,Y方向上误差的影响更大。结论 ArcCHECK摆位误差对直肠癌VMAT计划的剂量验证通过率有较大影响,直肠癌临床放疗中尤其要严格控制Y方向的摆位误差。
Objective To evaluate the effect of the ArcCHECK setup error on the dosimetric verification pass rate of of volumetric modulated arc therapy(VMAT) in the treatment of rectal cancer. Methods The VMAT plans of 10 cases with rectal cancer were collected, and the dose distribution was measured by ArcCHECK array. By simulating ArcCHECK setup errors of 3 mm, 4 mm, and 5 mm in the X, Y, and Z directions at the isocenter location on TPS, the pass rate of each plan was obtained using 3%/3 mm of absolute dose Gamma as the evaluation index. Results The average pass rate of the original plans was more than 99%. After introducing ArcCHECK setup errors in three directions, the dose verification pass rate of VMAT for rectal cancer decreased to a certain extent, and the higher the error, the lower the pass rate. After introducing the errors, the plan's pass rate was statistically significant compared with the original plan's pass rate(P<0.05). The in?uence of errors in different directions on the pass rate was different, and the in?uence of errors in the Y direction was greater. Conclusion ArcCHECK setup errors have a great effect on the dose verification pass rate of the VMAT plans for rectal cancer. In clinical radiatherapy for rectal cancer, we need to strictly control the setup error of Y direction.
Objective To evaluate the effect of the ArcCHECK setup error on the dosimetric verification pass rate of of volumetric modulated arc therapy(VMAT) in the treatment of rectal cancer. Methods The VMAT plans of 10 cases with rectal cancer were collected, and the dose distribution was measured by ArcCHECK array. By simulating ArcCHECK setup errors of 3 mm, 4 mm, and 5 mm in the X, Y, and Z directions at the isocenter location on TPS, the pass rate of each plan was obtained using 3%/3 mm of absolute dose Gamma as the evaluation index. Results The average pass rate of the original plans was more than 99%. After introducing ArcCHECK setup errors in three directions, the dose verification pass rate of VMAT for rectal cancer decreased to a certain extent, and the higher the error, the lower the pass rate. After introducing the errors, the plan's pass rate was statistically significant compared with the original plan's pass rate(P<0.05). The in?uence of errors in different directions on the pass rate was different, and the in?uence of errors in the Y direction was greater. Conclusion ArcCHECK setup errors have a great effect on the dose verification pass rate of the VMAT plans for rectal cancer. In clinical radiatherapy for rectal cancer, we need to strictly control the setup error of Y direction.
引文
[1]戴建荣,胡逸民,张红志,等.针对患者调强放射治疗计划的剂量学验证[J].中华放射肿瘤学杂志,2004,13(3):89-93.
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[7]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.
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[11]井笛,杨振,申良方.摆位误差对体重减轻鼻咽癌患者脑干剂量影响[J].中华放射肿瘤学杂志,2016,25(12):1331-1334.
[12]俞海东,蒋振东,陈爱辉,等.探讨鼻咽癌调强计划剂量分布和验证通过率受摆位误差的影响[J].肿瘤基础与临床,2017,30(4):347-350.
[13]孙晓欢,谭丽娜,马奎,等.摆位误差对VMAT计划剂量学验证的影响[J].中华放射肿瘤学杂志,2014,23(6):513-514.
[14]张利文,石锦平,谢秋英,等.等中心偏移误差对容积调强放疗计划的剂量影响[J].肿瘤预防与治疗,2012,25(3):160-163.
[15]张彪,贾鹏飞,汤乐民.摆位稳健性对IMRT与VMAT剂量学影响研究[J].中华放射肿瘤学杂志,2016,25(7):676-680.
[16]孙小杨,杨波,庞皓文,等.Mapcheck摆位误差对调强验证计划Gamma通过率的影响[J].医疗卫生装备,2017,38(1):88-90.
[17]颜红兵,徐建,叶景乐,等.食管癌患者X轴、Y轴、Z轴3个方向的摆位误差对剂量通过率的影响[J].医疗装备,2017,30(17):26-27.
[2]Ezzell GA,Galvin JM,Low D,et al.Guidance document on delivery,treatment planning,and clinical implementation of IMRT:Report of the IMRT subcommittee of the AAPMradiation therapy committee[J].Med Phys,2003,30(8):2089-2115
[3]Xing L,Lin Z,Donaldson SS,et al.Dosimetric effects of patient displacement and collimator and gantry angle misalignment on intensity modulated radiation therapy[J].Radiother Oncol,2000,56(1):97-108.
[4]Lomax AJ.Intensity modulated proton therapy and its sensitivity to treatment uncertainties 1:the potential effects of calculational uncertainties[J].Phys Med Biol,2008,53(4):1027-1042.
[5]Cantone MC,Ciocca M,Dionisi F,et al.Application of failure mode and effects analysis to treatment planning in scanned proton beam radiotherapy[J].Radiat Oncol,2013,8:127.
[6]Li G,Zhang Y,Jiang X,et al.Evaluation of the ArcCHECKQA system for IMRT and VMAT verification[J].Phys Med,2013,29(3):295-303.
[7]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.
[8]Low DA.DempseyJF.Evaluation of the gamma dose distribution comparison method[J].Med Phys,2003,30:2455-2464.
[9]Siebers JV,Keall PJ,Wu Q,et al.Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans[J].Int J Radiat Oncol Boil Phys,2005,63:422-433.
[10]Lai YL,Yang SN,Liang JA,et al.Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidance[J]Radiat Oncol,2014,9(1):1-8.
[11]井笛,杨振,申良方.摆位误差对体重减轻鼻咽癌患者脑干剂量影响[J].中华放射肿瘤学杂志,2016,25(12):1331-1334.
[12]俞海东,蒋振东,陈爱辉,等.探讨鼻咽癌调强计划剂量分布和验证通过率受摆位误差的影响[J].肿瘤基础与临床,2017,30(4):347-350.
[13]孙晓欢,谭丽娜,马奎,等.摆位误差对VMAT计划剂量学验证的影响[J].中华放射肿瘤学杂志,2014,23(6):513-514.
[14]张利文,石锦平,谢秋英,等.等中心偏移误差对容积调强放疗计划的剂量影响[J].肿瘤预防与治疗,2012,25(3):160-163.
[15]张彪,贾鹏飞,汤乐民.摆位稳健性对IMRT与VMAT剂量学影响研究[J].中华放射肿瘤学杂志,2016,25(7):676-680.
[16]孙小杨,杨波,庞皓文,等.Mapcheck摆位误差对调强验证计划Gamma通过率的影响[J].医疗卫生装备,2017,38(1):88-90.
[17]颜红兵,徐建,叶景乐,等.食管癌患者X轴、Y轴、Z轴3个方向的摆位误差对剂量通过率的影响[J].医疗装备,2017,30(17):26-27.