Bergman A, Vollans E, Duzenli C
British Columbia Cancer Agency, Vancouver Centre.
Med Phys. 2012 Jul;39(7Part3):4630. doi: 10.1118/1.4740138.
The purpose of this study was to determine whether VMAT (Varian RapidArc ™) treatment planning and delivery performance is in compliance with accepted quality assurance tolerances developed for sliding window IMRT. We present an analysis of data for over 1300 patients treated with VMAT and IMRT over a period of three years. Data was acquired on 6 dosimetrically matched linacs for sites including head and neck, brain, gynaecological, and a variety of other cancer cases treated with 6 MV. We have demonstrated that it is possible to dosimetrically match multiple Varian iX linacs with the millennium series MLC using a sliding gap and intercept test. QA is performed by Monte Carlo simulation and ion chamber measurement comparisons with Varian Eclipse TPS as well as linac log file analysis of MLC positions, gantry angles and monitor units on each patient. Point dose and 3D gamma analysis indicate that agreement between Eclipse and measurement or Monte Carlo calculation is site specific, with the dosimetric leaf gap parameter in Eclipse optimized for the most frequently treated site Point dose agreement within 2% and gamma pass rate of > 95% (3%/ 3 mm) is achievable for all sites for both IMRT and VMAT. Linac log file analysis indicates that planned MLC positions are achieved within 2 mm >99.7% of the time for both sliding window IMRT and VMAT. Planned gantry angles are achieved within 0.6 mm 99.8% of the time and planned MU's within 0.1 mm are achieved 99.8% of the time for VMAT.
本研究的目的是确定容积调强弧形治疗(Varian RapidArc™)的治疗计划和实施性能是否符合为滑动窗口调强放疗制定的公认质量保证公差。我们对三年期间接受容积调强弧形治疗和调强放疗的1300多名患者的数据进行了分析。在6台剂量学匹配的直线加速器上采集了数据,治疗部位包括头颈部、脑部、妇科以及多种其他用6兆伏治疗的癌症病例。我们已经证明,使用滑动间隙和截距测试,可以在剂量学上使多台Varian iX直线加速器与千年系列多叶准直器相匹配。通过蒙特卡罗模拟以及与Varian Eclipse治疗计划系统的电离室测量比较,以及对每位患者的多叶准直器位置、机架角度和监测单位的直线加速器日志文件分析来进行质量保证。点剂量和三维伽马分析表明,Eclipse与测量值或蒙特卡罗计算值之间的一致性因部位而异,Eclipse中的剂量学叶片间隙参数针对最常见的治疗部位进行了优化。对于调强放疗和容积调强弧形治疗的所有部位,点剂量一致性在2%以内且伽马通过率>95%(3%/3毫米)是可以实现的。直线加速器日志文件分析表明,对于滑动窗口调强放疗和容积调强弧形治疗,计划的多叶准直器位置在99.7%的时间内能够在2毫米内实现。对于容积调强弧形治疗,计划的机架角度在99.8%的时间内能够在0.6毫米内实现,计划的监测单位在99.8%的时间内能够在0.1毫米内实现。