[1]程晓龙,刘吉平,杨双燕,等. 基于螺旋断层放疗的立体定向放射治疗多参量数据分析[J].中国医学物理学杂志,2019,36(3):259-264.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.003]
　CHENG Xiaolong,LIU Jiping,YANG Shuangyan,et al. Multiparameter data analysis of stereotactic body radiotherapy based on helical tomotherapy[J].Chinese Journal of Medical Physics,2019,36(3):259-264.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.003]
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 基于螺旋断层放疗的立体定向放射治疗多参量数据分析()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第3期
页码:
259-264
栏目:
医学放射物理
出版日期:
2019-03-25

文章信息/Info

Title:
 Multiparameter data analysis of stereotactic body radiotherapy based on helical tomotherapy
文章编号:
1005-202X（2019）03-0259-06
作者:
 程晓龙; 刘吉平; 杨双燕; 时建芳
 浙江省肿瘤医院放射物理室， 浙江 杭州 310022
Author(s):
 CHENG Xiaolong;  LIU Jiping;  YANG Shuangyan;  SHI Jianfang
 Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou 310022, China
关键词:
 ; 螺旋断层放疗; 立体定向放射治疗; 剂量验证; 摆位误差
Keywords:
 ; Keywords: helical tomotherapy;  stereotactic body radiotherapy;  dose verification;  setup error
分类号:
R812
DOI:
DOI:10.3969/j.issn.1005-202X.2019.03.003
文献标志码:
A
摘要:
 目的：探讨基于螺旋断层治疗技术的立体定向放射治疗（SBRT）计划设计和剂量验证的方法，并根据摆位误差确定靶区边界外扩值。方法：汇总近3年行螺旋断层放疗的SBRT病例，并遴选出45例；分析计划设计的过程，明确各项参数的设置规则；统计分析剂量验证中绝对剂量偏差及γ（3 mm/3%）通过率；根据285次摆位误差计算靶区边界外扩值（ITV-PTV）。结果：（1）确定了螺距值的设置方法，给出了经验公式，并依据机架最佳旋转周期制作了分次剂量与螺距的对照表格。（2）治疗计划剂量验证的绝对剂量偏差平均值为-0.71%±1.32%，γ通过率平均值为98.1%±1.1%。（3）热塑体模组在左右（X）、头脚（Y）、前后（Z）和横断面上的旋转（Roll）的平均摆位误差分别为（1.71±1.62） mm、（1.21±1.28） mm、（1.18±1.41） mm和0.55°±1.02°，对应的X、Y、Z方向的ITV-PTV外扩边界值分别为5.41、3.92、3.94 mm；真空垫组X、Y、Z和Roll的平均摆位误差分别为（1.68±1.71） mm、（1.23±1.57） mm、（1.22±1.31） mm和0.73°±1.21°，对应的X、Y、Z方向的ITV-PTV外扩边界值分别为5.40、4.13、3.97 mm。结论：SBRT计划设计的关键在于参数设置及计划执行时间。SBRT的剂量验证通过率较高，可适当提升评价标准，即绝对剂量< ±3%，γ（3 mm/3%）<1通过率>95%。摆位误差与放疗设备、固定技术、配准方法、患者个人和放疗师的操作密切相关，有必要根据实际情况确定可靠的靶区边界外扩值，为临床提供技术支持。
Abstract:
 Abstract: Objective To discuss the methods for stereotactic body radiotherapy (SBRT) plan design and dose verification based on helical tomography, and to determine the margin value of target areas according to setup errors. Methods Forty-five cases of SBRT treated with helical tomography in the last 3 years were enrolled in this study. The process of radiotherapy plan design was analyzed, and the setting rules of various parameters were clarified. Then the absolute dose deviation and Gamma (3 mm/3%) passing rate was analyzed. Finally, the ITV-PTV margin values were calculated based on 285 setup errors. Results The pitch setting method was determined; the empirical formula was given; and the comparison table of fractional dose and pitch was made according to the optimal gantry period. The mean value of absolute dose deviation and Gamma passing rate of SBRT were -0.71%±1.32% and 98.1%±1.1%, respectively. The mean setup errors of X, Y, Z and Roll in thermoplastic body membrane group were (1.71±1.62) mm, (1.21±1.28) mm, (1.18±1.41) mm and 0.55°±1.02°, respectively, and the corresponding ITV-PTV margin values in X, Y and Z directions were 5.41, 3.92 and 3.94 mm, respectively. The mean setup errors of X, Y, Z and Roll in vacuum negative pressure pad group were (1.68±1.71) mm, (1.23±1.57) mm, (1.22±1.31) mm and 0.73°±1.21°, respectively, and the corresponding ITV-PTV margin values in X, Y and Z directions were 5.40, 4.13 and 3.97 mm. Conclusion The parameter setting and plan execution time are critical in SBRT plan design. The passing rate of SBRT dose verification is high, therefore, the evaluation standard could be improved appropriately, such as absolute dose < ±3% and Gamma (3mm/3%) <1 passing rate >95%. The setup error is related to the radiotherapy equipment, fixed technology, registration method, patients themselves and the operation of radiologist. It is necessary to determine the reliable margin value according to the actual condition, so as to provide technical supports in clinic.

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备注/Memo

备注/Memo:
 【收稿日期】2018-09-01
【基金项目】浙江省医药卫生技术成果项目（2018PY004）
【作者简介】程晓龙，硕士，工程师，研究方向：Tomotherapy质量控制及放疗计划设计，E-mail: chengxl@zjcc.org.cn
更新日期/Last Update: 2019-03-25