Royer P, Marchesi V, Rousseau V, Buchheit I, Wolf D, Peiffert D, Noël A
Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54500 Nancy, France; UMR 7039, centre de recherche en automatique de Nancy (Cran), BP 70239, 54506 Vandœuvre-lès-Nancy cedex, France; UMR 7039, université de Lorraine, BP 70239, 54506 Vandœuvre-lès-Nancy cedex, France; UMR 7039, CNRS, BP 70239, 54506 Vandœuvre-lès-Nancy cedex, France.
Département de radiothérapie, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54500 Nancy, France.
Cancer Radiother. 2014 Jun;18(3):183-90. doi: 10.1016/j.canrad.2014.03.006. Epub 2014 May 1.
In vivo dosimetry transit using portal imaging is a promising approach for quality assurance in radiotherapy. A comparative evaluation was conducted between a commercial solution, EPIgray(®) and an in vivo dosimetry control reference using semiconductors diodes.
The performance of the two in vivo dosimetry methods was assessed. The primary endpoint was the dose deviation between the reconstructed dose at the prescription point and the measured dose using the ionization chamber in phantoms or the calculated predictive dose by the treatment planning system with patients. The deviation threshold was set to ±5%. In total, 107 patients were prospectively included and treated with 3D-conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques for tumours of the brain, chest and head and neck.
The dosimetric accuracy of EPIgray(®) in phantom were comparable to diodes in terms of repeatability (0.11%), reproducibility (0.29-0.51%) with a mean dose deviation of 0.17% (SD: 1.11). The rates of radiotherapy sessions out of the tolerance for the brain (3D-CRT and IMRT), thorax (3D-CRT) and the head and neck (IMRT) were respectively 0%, 9.6% and 5.3% with a mean dose deviation ranging between 0.49% and 1.53%. The mean of dose deviation between three consecutive sessions with EPIgray(®) validates 99.1% of treatments.
The performance of EPIgray(®) in in vivo dosimetry is consistent with the recommendations of the European Society for Radiotherapy and Oncology (ESTRO) and equivalent to semiconductor diodes for 3D-CRT. It also allows adequate control for IMRT, which is technically difficult to perform with the diodes.
利用门静脉成像进行体内剂量测定是放射治疗质量保证的一种有前景的方法。对一种商业解决方案EPIgray(®)和使用半导体二极管的体内剂量测定对照参考物进行了比较评估。
评估了两种体内剂量测定方法的性能。主要终点是在体模中处方点处重建剂量与使用电离室测量的剂量之间的剂量偏差,或治疗计划系统对患者计算的预测剂量之间的偏差。偏差阈值设定为±5%。总共前瞻性纳入了107例患者,采用三维适形放疗(3D-CRT)或调强放疗(IMRT)技术治疗脑、胸、头颈部肿瘤。
在体模中,EPIgray(®)的剂量测定准确性在重复性(0.11%)、再现性(0.29 - 0.51%)方面与二极管相当,平均剂量偏差为0.17%(标准差:1.11)。脑(3D-CRT和IMRT)、胸部(3D-CRT)和头颈部(IMRT)超出耐受范围的放疗疗程率分别为0%、9.6%和5.3%,平均剂量偏差在0.49%至1.53%之间。使用EPIgray(®)的三个连续疗程之间的平均剂量偏差验证了99.1%的治疗。
EPIgray(®)在体内剂量测定中的性能符合欧洲放射治疗与肿瘤学会(ESTRO)的建议,并且对于3D-CRT等同于半导体二极管。它也允许对IMRT进行充分控制,而二极管在技术上难以对IMRT进行控制。