Department of Radiation Oncology, Cancer Therapy and Research Center at University of Texas Health Sciences Center, San Antonio, Texas 78229, USA.
Med Phys. 2009 Oct;36(10):4765-75. doi: 10.1118/1.3213523.
Radiation therapy has witnessed a plethora of innovations and developments in the past 15 years. Since the introduction of computed tomography for treatment planning there has been a steady introduction of new methods to refine treatment delivery. Imaging continues to be an integral part of the planning, but also the delivery, of modern radiotherapy. However, all the efforts of image guided radiotherapy, intensity-modulated planning and delivery, adaptive radiotherapy, and everything else that we pride ourselves in having in the armamentarium can fall short, unless there is an accurate dose-calculation algorithm. The agreement between the calculated and delivered doses is of great significance in radiation therapy since the accuracy of the absorbed dose as prescribed determines the clinical outcome. Dose-calculation algorithms have evolved greatly over the years in an effort to be more inclusive of the effects that govern the true radiation transport through the human body. In this Vision 20/20 paper, we look back to see how it all started and where things are now in terms of dose algorithms for photon beams and the inclusion of tissue heterogeneities. Convolution-superposition algorithms have dominated the treatment planning industry for the past few years. Monte Carlo techniques have an inherent accuracy that is superior to any other algorithm and as such will continue to be the gold standard, along with measurements, and maybe one day will be the algorithm of choice for all particle treatment planning in radiation therapy.
在过去的 15 年中，放射治疗见证了众多的创新和发展。自引入计算机断层扫描用于治疗计划以来，不断引入新的方法来完善治疗的实施。成像一直是规划的一个组成部分，但也是现代放射治疗的实施的一个组成部分。然而，所有图像引导放射治疗、强度调制计划和实施、自适应放射治疗的努力，以及我们引以为豪的所有其他设备，如果没有准确的剂量计算算法，都可能会失败。在放射治疗中，计算剂量和实际剂量之间的一致性非常重要，因为规定的吸收剂量的准确性决定了临床结果。为了更全面地考虑控制真正穿过人体的辐射传输的影响，剂量计算算法多年来已经有了很大的发展。在这篇 20/20 愿景的论文中，我们回顾了过去的发展历程，以及目前光子束剂量算法和组织非均匀性纳入方面的情况。卷积叠加算法在过去几年中一直主导着治疗计划行业。蒙特卡罗技术具有优于任何其他算法的固有准确性，因此将继续成为金标准，与测量一起，也许有一天将成为所有粒子放射治疗计划的首选算法。
