Wang Xiaoyong, Chen Lixin, Xie Conghua, Wang Dajiang, Chen Gaili, Fu Zhengming, Liu Hui
Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, 430071 Wuhan, China.
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China.
Oncotarget. 2017 Nov 30;8(65):109619-109631. doi: 10.18632/oncotarget.22758. eCollection 2017 Dec 12.
To evaluate the Edose system, a novel three-dimensional (3D) dose monitoring system based on electronic portal imaging device (EPID), prior to clinical application, we analyzed the preliminary clinical data using Edose system in patients receiving intensity-modulated radiation therapy (IMRT).
After the physical modeling, the measured results from the Edose system were examined in homogeneous and inhomogeneous phantoms, respectively. To verify the accuracy of the Edose system, we compared its results with testing results from ionization chamber, measurement matrix (Delta4) and dosimetric films. The dosimetric performance of the Edose system was evaluated in 12 randomly selected patients with IMRT and VMAT, and the measured results were compared with the treatment plans.
Compared with the measured results, the dose difference at the center of target volume was (0.12±0.91)% and (0.03±0.85)%, the γ pass rate was (94.18±1.69)% and (95.24±1.62)% (3mm/3%)for homogeneous and inhomogeneous phantoms, respectively. For IMRT patients, the dose difference at the center of target volume was (0.75±1.53)%, and the γ pass rates were (89.11±3.24)% (3mm/3%) and (96.40±1.47)% (3mm/5%), respectively. Compared with the results of DVH, the maximum differences of PTVs and mostly organs at risk were all within 3%. For VMAT patients, the γ pass rates were (93.04 ± 2.62)% (3mm/3%) and (97.92 ± 1.38)% (3mm/5%), respectively.
dose monitoring may further improve the safety and quality assurance for radiation therapy. But rigorous clinical testing is required before putting the existing commercial systems into clinical application. In addition, more clinical experiences and better workflows for using the Edose system are needed.
为在临床应用前评估Edose系统，这是一种基于电子射野影像装置（EPID）的新型三维（3D）剂量监测系统，我们分析了使用Edose系统对接受调强放射治疗（IMRT）患者的初步临床数据。
在物理建模后，分别在均匀和非均匀模体中检查Edose系统的测量结果。为验证Edose系统的准确性，我们将其结果与电离室、测量矩阵（Delta4）和剂量胶片的测试结果进行比较。在12例随机选择的接受IMRT和容积调强弧形治疗（VMAT）的患者中评估Edose系统的剂量学性能，并将测量结果与治疗计划进行比较。
与测量结果相比，均匀和非均匀模体中靶区中心的剂量差异分别为（0.12±0.91）%和（0.03±0.85）%，γ通过率分别为（94.18±1.69）%和（95.24±1.62）%（3mm/3%）。对于IMRT患者，靶区中心的剂量差异为（0.75±1.53）%，γ通过率分别为（89.11±3.24）%（3mm/3%）和（96.40±1.47）%（3mm/5%）。与剂量体积直方图（DVH）结果相比，计划靶体积（PTV）和大多数危及器官的最大差异均在3%以内。对于VMAT患者，γ通过率分别为（93.04±2.62）%（3mm/3%）和（97.92±1.38）%（3mm/5%）。
剂量监测可能会进一步提高放射治疗的安全性和质量保证。但在将现有商业系统投入临床应用之前，需要进行严格的临床测试。此外，还需要更多使用Edose系统的临床经验和更好的工作流程。
