Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Med Phys. 2010 Jun;37(6):2638-44. doi: 10.1118/1.3397807.
The potential for detrimental incidents and the ever increasing complexity of patient treatments emphasize the need for accurate dosimetric verification in radiotherapy. For this reason, all curative treatments are verified, either pretreatment or in vivo, by electronic portal imaging device (EPID) dosimetry in the Radiation Oncology Department of The Netherlands Cancer Institute-Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands. Since the clinical introduction of the method in January 2005 until August 2009, treatment plans of 4337 patients have been verified. Among these plans, 17 serious errors were detected that led to intervention. Due to their origin, nine of these errors would not have been detected with pretreatment verification. The method is illustrated in detail by the case of a plan transfer error detected in a 5 x 5 Gy intensity-modulated radiotherapy (IMRT) rectum treatment. The EPID reconstructed dose at the isocenter was 6.3% below the planned value. Investigation of the plan transfer chain revealed that due to a network transfer error, the plan was corrupted. 3D analysis of the acquired EPID data revealed serious underdosage of the planning target volume: On average 11.6%, locally up to 20%. This report shows the importance of in vivo (EPID) dosimetry for all treatment plans as well as the ability of the method to assess the dosimetric impact of deviations found.
在放射肿瘤学部门，荷兰癌症研究所-安东尼范列文虎克医院，阿姆斯特丹，荷兰，所有的治疗性治疗都需要通过电子射野影像装置（EPID）剂量学进行精确的剂量验证，因为存在潜在的有害事件和患者治疗日益复杂。自 2005 年 1 月该方法临床应用以来，截至 2009 年 8 月，已经对 4337 例患者的治疗计划进行了验证。在这些计划中，发现了 17 例严重错误，需要进行干预。由于这些错误的来源，其中 9 例错误在预处理验证中无法检测到。通过在一个 5×5Gy 强度调制放疗（IMRT）直肠治疗中发现的计划传输错误的病例详细说明了该方法。在等中心处，EPID 重建的剂量比计划值低 6.3%。对计划传输链的调查显示，由于网络传输错误，计划被损坏。对获得的 EPID 数据的 3D 分析显示，计划靶体积的剂量不足严重：平均为 11.6%，局部高达 20%。本报告表明，对于所有治疗计划，体内（EPID）剂量学的重要性以及该方法评估发现偏差的剂量影响的能力。
