Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Rome, Italy.
INFN Sezione di Roma I, Rome, Italy.
Sci Rep. 2020 Nov 26;10(1):20735. doi: 10.1038/s41598-020-77843-z.
The high dose conformity and healthy tissue sparing achievable in Particle Therapy when using C ions calls for safety factors in treatment planning, to prevent the tumor under-dosage related to the possible occurrence of inter-fractional morphological changes during a treatment. This limitation could be overcome by a range monitor, still missing in clinical routine, capable of providing on-line feedback. The Dose Profiler (DP) is a detector developed within the INnovative Solution for In-beam Dosimetry in hadronthErapy (INSIDE) collaboration for the monitoring of carbon ion treatments at the CNAO facility (Centro Nazionale di Adroterapia Oncologica) exploiting the detection of charged secondary fragments that escape from the patient. The DP capability to detect inter-fractional changes is demonstrated by comparing the obtained fragment emission maps in different fractions of the treatments enrolled in the first ever clinical trial of such a monitoring system, performed at CNAO. The case of a CNAO patient that underwent a significant morphological change is presented in detail, focusing on the implications that can be drawn for the achievable inter-fractional monitoring DP sensitivity in real clinical conditions. The results have been cross-checked against a simulation study.
当使用碳离子进行粒子治疗时，高剂量一致性和健康组织保护得以实现，这就要求在治疗计划中考虑安全因素，以防止由于分次间形态变化可能导致肿瘤剂量不足。这种限制可以通过仍在临床常规中缺失的范围监视器来克服，该监视器能够提供在线反馈。剂量剖面仪（DP）是在创新的适形束内剂量测量解决方案（INSIDE）合作框架内开发的探测器，用于监测 CNAO 设施（意大利国家肿瘤放射治疗中心）的碳离子治疗，利用检测从患者体内逃逸的带电二次碎片。通过比较在该监测系统首次临床试验中所接受的分次治疗中获得的碎片发射图谱，证明了 DP 检测分次间变化的能力。本文详细介绍了一位 CNAO 患者的情况，该患者经历了显著的形态变化，重点关注了在实际临床条件下可实现的分次间 DP 监测灵敏度的相关问题。结果已经与模拟研究进行了交叉检查。
