Misson-Yates Sarah, Naeem Marium, Palmer Isabel, Holden Eleanor, Hedley Owen, McGovern Mark, Morris Stephen, Greener Anthony G
Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, SE1 9RT, London, UK.
Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, SE1 9RT, London, UK.
BJR Open. 2019 Jul 20;1(1):20190008. doi: 10.1259/bjro.20190008. eCollection 2019.
This paper reports on the rationalization of a substantial pool of dosimetry (IVD) data from patients treated with total skin electron beam therapy (TSEBT) and the application of this to verify the accurate delivery of TSEBT when changing linac manufacturer.
Thermoluminescent dosimeter IVD data from 149 patients were analyzed comparing the population mean and standard deviation for each site. The number of sites required to confirm the prescribed dose were reviewed considering both dosimetric and clinical relevance. The reduced sites were then used to assess the continued dosimetric accuracy on new equipment and the results were compared statistically using the Mann-Witney test.
The trunk dose measurement points were reduced from nine to six and five extra trunk sites were identified and reviewed clinically prior to removal.Following change in manufacturer the trunk dose points showed no statistically significant change and confirmed that patients had received within 1.3% of the intended mean trunk dose using both delivery methods.A statistically significant change in 4 out of the 13 extra trunk sites was seen following the move to the new centre. However, all but one site showed a change of less than 1 standard deviation.
The total number of measurement points per patient were reduced from 27 to 19 which constituted a 25% saving in preparation and read out.Accurate delivery of prescribed dose was confirmed following measurement point reduction for treatments delivered on linacs from two different manufacturers.
Proven methodology for rationalization of IVD measurements for TSEBT.
本文报告了对大量接受全身皮肤电子束治疗（TSEBT）患者的剂量测定（体外诊断，IVD）数据进行合理化处理，并将其应用于在更换直线加速器制造商时验证TSEBT的准确给药情况。
分析了149例患者的热释光剂量计IVD数据，比较每个部位的总体均值和标准差。考虑到剂量学和临床相关性，对确认规定剂量所需的部位数量进行了审查。然后使用减少后的部位评估新设备上剂量测定的持续准确性，并使用曼-惠特尼检验对结果进行统计学比较。
躯干剂量测量点从9个减少到6个，另外确定了5个躯干部位，并在去除前进行了临床审查。更换制造商后，躯干剂量点没有显示出统计学上的显著变化，并证实患者使用两种给药方法接受的剂量均在预期平均躯干剂量的1.3%以内。搬到新中心后，13个额外躯干部位中有4个出现了统计学上的显著变化。然而，除了一个部位外，所有部位的变化都小于1个标准差。
每位患者的测量点总数从27个减少到19个，这在准备和读出方面节省了25%。在减少测量点后，确认了在来自两家不同制造商的直线加速器上进行的治疗中规定剂量的准确给药。
已证实的TSEBT的IVD测量合理化方法。
