Keikhai Farzaneh Mohammad Javad, Momennezhad Mehdi, Naseri Shahrokh
PhD, Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
PhD, Department of Medical Physics, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
J Biomed Phys Eng. 2021 Apr 1;11(2):239-256. doi: 10.31661/jbpe.v0i0.948. eCollection 2021 Apr.
One of the most important challenges in treatment of patients with cancerous tumors of chest and abdominal areas is organ movement. The delivery of treatment radiation doses to tumor tissue is a challenging matter while protecting healthy and radio sensitive tissues. Since the movement of organs due to respiration causes a discrepancy in the middle of planned and delivered dose distributions. The moderation in the fatalistic effect of intra-fractional target travel on the radiation therapy correctness is necessary for cutting-edge methods of motion remote monitoring and cancerous growth irradiancy. Tracking respiratory milling and implementation of breath-hold techniques by respiratory gating systems have been used for compensation of respiratory motion negative effects. Therefore, these systems help us to deliver precise treatments and also protect healthy and critical organs. It seems aspiration should be kept under observation all over treatment period employing tracking seed markers (e.g. fiducials), skin surface scanners (e.g. camera and laser monitoring systems) and aspiration detectors (e.g. spirometers). However, these systems are not readily available for most radiotherapy centers around the word. It is believed that providing and expanding the required equipment, gated radiotherapy will be a routine technique for treatment of chest and abdominal tumors in all clinical radiotherapy centers in the world by considering benefits of respiratory gating techniques in increasing efficiency of patient treatment in the near future. This review explains the different technologies and systems as well as some strategies available for motion management in radiotherapy centers.
治疗胸部和腹部癌症肿瘤患者面临的最重要挑战之一是器官运动。在保护健康和放射敏感组织的同时，将治疗辐射剂量输送到肿瘤组织是一项具有挑战性的任务。由于呼吸引起的器官运动导致计划剂量分布和实际输送剂量分布之间存在差异。对于前沿的运动远程监测和癌性生长辐照方法而言，减轻分次内靶区移动对放射治疗正确性的致命影响是必要的。通过呼吸门控系统跟踪呼吸运动并实施屏气技术已被用于补偿呼吸运动的负面影响。因此，这些系统有助于我们进行精确治疗，同时保护健康和关键器官。在整个治疗期间，似乎应使用跟踪种子标记物（如基准标记）、皮肤表面扫描仪（如摄像头和激光监测系统）和呼吸探测器（如肺活量计）对呼吸进行监测。然而，这些系统并非世界上大多数放疗中心都能轻易获得。人们认为，考虑到呼吸门控技术在提高患者治疗效率方面的益处，通过提供和扩展所需设备，门控放射治疗在不久的将来将成为全球所有临床放疗中心治疗胸部和腹部肿瘤的常规技术。本综述解释了放疗中心可用于运动管理的不同技术、系统以及一些策略。
