头颈部患者无行动水平方案的有效性——时间考量
Effectiveness of the No action level protocol for head & neck patients - Time considerations.
作者信息
Kukolowicz Pawel, Mietelska Monika, Kiprian Dorota
机构信息
Medical Department Physics Department, Maria Sklodowska - Curie Memorial Cancer Center and Institute of Oncology, 5 Roentgena Street, 02-81 Warsaw, Poland.
Biomedical Physics Division, Faculty of Physics, University of Warsaw, 5 Pasteur Street, 02-093 Warsaw, Poland.
出版信息
Rep Pract Oncol Radiother. 2020 Sep-Oct;25(5):828-831. doi: 10.1016/j.rpor.2020.04.005. Epub 2020 Apr 12.
BACKGROUND
The No Action Protocol (NAL) was used to diminish the systematic set-up error. Recently, owing to the development of image registration technologies, the on-line positioning control is more often used. This method significantly reduces the CTV-PTV margin at the expense of the lengthening of a treatment session. The efficiency of NAL in decreasing the total treatment time for Head&Neck patients was investigated.
METHODS
Results of set-up control of 30 patients were analyzed. The set-up control was carried out on-line. For each patient and each fraction, the set-error and the time needed for making the set-up control procedure were measured. Next, retrospectively, the NAL was applied to this data. The number of initial errors (without interventions) and after NAL protocol were compared in terms of errors larger than 3 and 4 mm. The average and total time used for portal control was calculated and compared.
RESULTS
The number of setup errors in the posterior-anterior, inferior-superior, and right-left directions ≥3 mm and ≥4 mm were 98, 79, and 91 sessions and 44, 38 and 30 sessions out of 884 sessions. After NAL protocol the number of errors ≥3 mm and ≥4 mm decreased to 84, 57, and 39 sessions and 31, 15 and 10 sessions, respectively. The average time needed for one set-up control was 5.1 min. NAL protocol allows saving 4049 min for the whole group.
CONCLUSIONS
For locations where the random set-up errors are small, the NAL enables a very precise treatment of patients. Implementation of this protocol significantly decreases the total treatment time.
背景
无动作协议（NAL）曾被用于减少系统设置误差。近来，由于图像配准技术的发展，在线定位控制的应用更为频繁。这种方法显著减小了临床靶区（CTV）与计划靶区（PTV）的边界，但代价是治疗疗程延长。本研究调查了NAL在缩短头颈癌患者总治疗时间方面的效果。
方法
分析了30例患者的设置控制结果。设置控制为在线进行。对每位患者的每个分次，测量设置误差以及进行设置控制程序所需的时间。接下来，对这些数据进行回顾性分析，应用NAL。比较初始误差（无干预）和NAL协议应用后的误差，误差大于3毫米和4毫米的数据纳入比较。计算并比较门控的平均时间和总时间。
结果
在884个分次中，前后、上下和左右方向上设置误差≥3毫米和≥4毫米的次数分别为98次、79次和91次，以及44次、38次和30次。应用NAL协议后，误差≥3毫米和≥4毫米的次数分别降至84次、57次和39次，以及31次、15次和10次。一次设置控制所需的平均时间为5.1分钟。NAL协议可为整个研究组节省4049分钟。
结论
对于随机设置误差较小的部位，NAL能实现对患者非常精确的治疗。实施该协议可显著缩短总治疗时间。
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