Karmanos Cancer Institute at McLaren-Flint, McLaren Proton Therapy Center, Flint, MI, USA.
Imaging and Radiation Oncology Core (IROC) Houston, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Med Phys. 2019 Aug;46(8):e678-e705. doi: 10.1002/mp.13622. Epub 2019 Jun 14.
Task Group (TG) 224 was established by the American Association of Physicists in Medicine's Science Council under the Radiation Therapy Committee and Work Group on Particle Beams. The group was charged with developing comprehensive quality assurance (QA) guidelines and recommendations for the three commonly employed proton therapy techniques for beam delivery: scattering, uniform scanning, and pencil beam scanning. This report supplements established QA guidelines for therapy machine performance for other widely used modalities, such as photons and electrons (TG 142, TG 40, TG 24, TG 22, TG 179, and Medical Physics Practice Guideline 2a) and shares their aims of ensuring the safe, accurate, and consistent delivery of radiation therapy dose distributions to patients.
To provide a basis from which machine-specific QA procedures can be developed, the report first describes the different delivery techniques and highlights the salient components of the related machine hardware. Depending on the particular machine hardware, certain procedures may be more or less important, and each institution should investigate its own situation.
In lieu of such investigations, this report identifies common beam parameters that are typically checked, along with the typical frequencies of those checks (daily, weekly, monthly, or annually). The rationale for choosing these checks and their frequencies is briefly described. Short descriptions of suggested tools and procedures for completing some of the periodic QA checks are also presented.
Recommended tolerance limits for each of the recommended QA checks are tabulated, and are based on the literature and on consensus data from the clinical proton experience of the task group members. We hope that this and other reports will serve as a reference for clinical physicists wishing either to establish a proton therapy QA program or to evaluate an existing one.
美国医学物理学家协会科学理事会下属的放射治疗委员会和粒子束工作组设立了工作组 224。该小组的任务是为散射、均匀扫描和铅笔束扫描这三种常用的质子治疗束传输技术制定全面的质量保证 (QA) 指南和建议。本报告补充了其他广泛使用的模式(如光子和电子)的治疗机性能的既定 QA 指南(TG142、TG40、TG24、TG22、TG179 和医学物理实践指南 2a),并分享了确保安全、准确和一致地向患者输送放射治疗剂量分布的目标。
为了提供制定特定于机器的 QA 程序的基础,本报告首先描述了不同的传输技术,并强调了相关机器硬件的重要组成部分。根据特定的机器硬件,某些程序可能更为重要或不重要,每个机构都应调查自己的情况。
本报告没有进行这样的调查,而是确定了通常检查的常见光束参数,以及这些检查的典型频率(每天、每周、每月或每年)。简要描述了选择这些检查及其频率的基本原理。还简短介绍了完成一些定期 QA 检查的建议工具和程序。
为每个推荐的 QA 检查列出了推荐的公差限制,这些限制基于文献和工作组成员的临床质子经验的共识数据。我们希望本报告和其他报告将为希望建立质子治疗 QA 计划或评估现有计划的临床物理学家提供参考。