Department of Radiation Oncology, University of Maryland, Baltimore, Maryland, USA.
J Appl Clin Med Phys. 2022 Apr;23(4):e13524. doi: 10.1002/acm2.13524. Epub 2022 Feb 7.
The GammaPod is a novel device for stereotactic breast treatments that employs 25 rotating Co-60 sources while the patient is continuously translated in three axes to deliver a highly conformal dose to the target. There is no commercial software available for independent second calculations. The purpose of this study is to determine an efficient way to estimate GammaPod treatment times based on target volume and use it as a second calculation for patient-specific quality assurance.
Fifty-nine GammaPod (Xcision Medical Systems, LLC.) breast cancer patient treatments were used as the fitting dataset for this study. Similar to the Curie-seconds concept in brachytherapy, we considered dose-rate × time/(prescribed dose) as a function of target volumes. Using a MATLAB (Mathworks, Natick, MA, USA) script, we generated linear (with 95% confidence interval (CI)) and quadratic fits and tested the resulting equations on an additional set of 30 patients.
We found a strong correlation between the dose-rate × time/(prescribed dose) and patients' target volumes for both the linear and quadratic models. The linear fit was selected for use and using the polyval function in MATLAB, a 95% CI graph was created to depict the accuracy of the prediction for treatment times. Testing the model on 30 additional patients with target volumes ranging from 20 to 188 cc yielded treatment times from 10 to 25 min that in all cases were within the predicted CI. The average absolute difference between the predicted and actual treatment times was 1.0 min (range 0-3.3 min). The average percent difference was 5.8% (range 0%-18.4%).
This work has resulted in a viable independent calculation for GammaPod treatment times. This method has been implemented as a spreadsheet that is ready for clinical use to predict and verify the accuracy of breast cancer treatment times.
GammaPod 是一种用于立体定向乳房治疗的新型设备,它使用 25 个旋转的 Co-60 源,同时患者在三个轴上连续平移,以将高度适形的剂量输送到靶标。目前没有商业软件可用于独立的二次计算。本研究的目的是确定一种基于靶体积估算 GammaPod 治疗时间的有效方法,并将其用作患者特定质量保证的二次计算。
将 59 例 GammaPod(Xcision Medical Systems,LLC.)乳腺癌患者的治疗作为本研究的拟合数据集。类似于近距离放射治疗中的居里秒概念,我们认为剂量率×时间/(规定剂量)是靶体积的函数。使用 MATLAB(Mathworks,Natick,MA,USA)脚本,我们生成了线性(置信区间为 95%)和二次拟合,并在另外 30 例患者的数据集上测试了结果方程。
我们发现剂量率×时间/(规定剂量)与患者的靶体积之间存在很强的相关性,对于线性和二次模型都是如此。选择线性拟合进行使用,并使用 MATLAB 中的 polyval 函数创建了 95%CI 图,以描绘治疗时间预测的准确性。在 30 例靶体积范围从 20 到 188cc 的额外患者上测试该模型,得出的治疗时间从 10 到 25 分钟,在所有情况下均在预测的 CI 内。预测和实际治疗时间之间的平均绝对差异为 1.0 分钟(范围为 0-3.3 分钟)。平均百分比差异为 5.8%(范围为 0%-18.4%)。
这项工作已经产生了一种可行的 GammaPod 治疗时间的独立计算方法。该方法已被实现为一个电子表格,可用于临床预测和验证乳腺癌治疗时间的准确性。