将TG-218行动限值应用于立体定向放射治疗（SRS）和立体定向体部放射治疗（SBRT）治疗前患者特异性质量保证。
Application of TG-218 action limits to SRS and SBRT pre-treatment patient specific QA.
作者信息
Xia Yuqing, Adamson Justus, Zlateva Yana, Giles Will
机构信息
Medical Physics Graduate Program, Duke Kunshan University, Kunshan, China 215316.
Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27708, USA.
出版信息
J Radiosurg SBRT. 2020;7(2):135-147.
Abstract
AAPM TG-218 provides recommendations for standard IMRT pre-treatment QA without giving specifics for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). In light of this, our purpose is to report our experience with applying TG-218 recommendations to a large multicenter clinical SRS and SBRT program for a range of diverse clinical pre-treatment QA systems. Pre-treatment QA systems included Delta4 (Scandidos), Portal Dosimetry (Varian Medical Systems), ArcCHECK (SunNuclear), and SRS MapCHECK (SunNuclear). Plans were stratified by technique for each QA system, and included intracranial and extracranial IMRT and VMAT (total QA cases n=275). Gamma analysis was re-analyzed with spatial/dose criteria combinations ranging from 1 to 3 mm and 1% to 4%, and action and tolerance limits were calculated per plan type and compared to the "universal" TG-218 action limit of 90%. The analysis indicated that spatial tolerance criteria could be tightened to 1 mm while still maintaining an in-control QA process for all QA systems evaluated.
摘要
美国医学物理学家协会（AAPM）的TG-218提供了标准调强放疗（IMRT）治疗前质量保证（QA）的建议，但未给出立体定向放射外科（SRS）和立体定向体部放疗（SBRT）的具体细节。鉴于此，我们的目的是报告我们将TG-218建议应用于一个大型多中心临床SRS和SBRT项目的经验，该项目涉及一系列不同的临床治疗前QA系统。治疗前QA系统包括Delta4（Scandidos公司）、门静脉剂量测定仪（瓦里安医疗系统公司）、ArcCHECK（太阳核子公司）和SRS MapCHECK（太阳核子公司）。针对每个QA系统，计划按技术进行分层，包括颅内和颅外IMRT以及容积调强弧形放疗（VMAT）（QA总病例数n = 275）。使用从1至3毫米和1%至4%的空间/剂量标准组合对伽马分析进行重新分析，并针对每种计划类型计算行动和公差限度，然后与90%的“通用”TG-218行动限度进行比较。分析表明，空间公差标准可以收紧至1毫米，同时仍能对所有评估的QA系统维持一个处于控制状态的QA流程。
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