旋转调强放射治疗的多机构剂量学审核
A multi-institutional dosimetry audit of rotational intensity-modulated radiotherapy.
作者信息
Clark Catharine H, Hussein Mohammad, Tsang Yatman, Thomas Russell, Wilkinson Dean, Bass Graham, Snaith Julia, Gouldstone Clare, Bolton Steve, Nutbrown Rebecca, Venables Karen, Nisbet Andrew
机构信息
Department of Medical Physics, Royal Surrey County Hospital, Guildford, UK; National Physical Laboratory, London, UK; NCRI Radiotherapy Trials Quality Assurance Group, UK.
Department of Medical Physics, Royal Surrey County Hospital, Guildford, UK; Centre for Nuclear and Radiation Physics, University of Surrey, UK.
出版信息
Radiother Oncol. 2014 Nov;113(2):272-8. doi: 10.1016/j.radonc.2014.11.015. Epub 2014 Nov 23.
BACKGROUND
Rotational IMRT (VMAT and Tomotherapy) has now been implemented in many radiotherapy centres. An audit to verify treatment planning system modelling and treatment delivery has been undertaken to ensure accurate clinical implementation.
MATERIAL AND METHODS
34 institutions with 43 treatment delivery systems took part in the audit. A virtual phantom planning exercise (3DTPS test) and a clinical trial planning exercise were planned and independently measured in each institution using a phantom and array combination. Point dose differences and global gamma index (γ) were calculated in regions corresponding to PTVs and OARs.
RESULTS
Point dose differences gave a mean (±sd) of 0.1±2.6% and 0.2±2.0% for the 3DTPS test and clinical trial plans, respectively. 34/43 planning and delivery combinations achieved all measured planes with >95% pixels passing γ<1 at 3%/3mm and rose to 42/43 for clinical trial plans. A statistically significant difference in γ pass rates (p<0.01) was seen between planning systems where rotational IMRT modelling had been designed for the manufacturer's own treatment delivery system and those designed independently of rotational IMRT delivery.
CONCLUSIONS
A dosimetry audit of rotational radiotherapy has shown that TPS modelling and delivery for rotational IMRT can achieve high accuracy of plan delivery.
背景
旋转调强放射治疗（容积调强弧形治疗和断层放疗）现已在许多放疗中心实施。已开展一项审核，以验证治疗计划系统建模和治疗实施情况，确保准确的临床应用。
材料与方法
34家机构的43套治疗实施系统参与了此次审核。在每家机构中，使用模体和阵列组合进行了虚拟模体计划演练（3D治疗计划系统测试）和临床试验计划演练，并进行独立测量。计算了与计划靶区和危及器官相对应区域的点剂量差异和全局伽马指数（γ）。
结果
对于3D治疗计划系统测试和临床试验计划，点剂量差异的均值（±标准差）分别为0.1±2.6%和0.2±2.0%。43个计划与实施组合中有34个在3%/3毫米标准下所有测量层面的γ<1时像素通过率>95%，临床试验计划的这一比例升至42/43。在为制造商自己的治疗实施系统设计旋转调强放射治疗建模的计划系统与独立于旋转调强放射治疗实施设计的计划系统之间，γ通过率存在统计学显著差异（p<0.01）。
结论
旋转放射治疗的剂量学审核表明，旋转调强放射治疗的治疗计划系统建模和实施可实现较高的计划实施精度。
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