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评估机架摆动的动态适形弧形治疗（DCAT）的可传递性及其对剂量的影响。

Evaluation of the deliverability of dynamic conformal arc therapy (DCAT) by gantry wobble and its influence on dose.

机构信息

Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.

Department of Radiation Oncology, Yonsei Cancer Center, Seoul, South Korea.

出版信息

Sci Rep. 2024 Mar 26;14(1):7134. doi: 10.1038/s41598-024-57644-4.

DOI:10.1038/s41598-024-57644-4
PMID:38532018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10965989/
Abstract

We aimed to investigate the deliverability of dynamic conformal arc therapy (DCAT) by gantry wobble owing to the intrinsic inter-segment break of the Elekta linear accelerator (LINAC) and its adverse influence on the dose to the patient. The deliverability of DCAT was evaluated according to the plan parameters, which affect the gantry rotation speed and resultant positional inaccuracies; the deliverability according to the number of control points and dose rates was investigated by using treatment machine log files and dosimetry devices, respectively. A non-negligible degradation in DCAT deliverability due to gantry wobble was observed in both the treatment machine log files and dosimetry devices. The resulting dose-delivery error occurred below a certain number of control points or above a certain dose rate. Dose simulations in the patient domain showed a similar impact on deteriorated deliverability. For targets located primarily in the isocenter, the dose differences were negligible, whereas for organs at risk located mainly off-isocenter, the dose differences were significant up to - 8.77%. To ensure safe and accurate radiotherapy, optimal plan parameters should be selected, and gantry angle-specific validations should be conducted before treatment.

摘要

我们旨在研究由于 Elekta 直线加速器 (LINAC) 的固有段间间隙以及其对患者剂量的不利影响，通过旋转机架摆动实现动态适形弧形治疗 (DCAT) 的可传递性。根据影响旋转机架速度和结果位置精度的计划参数评估 DCAT 的可传递性；通过使用治疗机日志文件和剂量测量设备分别研究根据控制点数量和剂量率的可传递性。在治疗机日志文件和剂量测量设备中都观察到由于旋转机架摆动导致 DCAT 可传递性的明显降低。在一定数量的控制点以下或一定剂量率以上会发生剂量传递误差。在患者域中的剂量模拟显示出对可传递性恶化的类似影响。对于主要位于等中心的靶区，剂量差异可以忽略不计，而对于主要位于等中心外的危及器官，剂量差异高达-8.77%。为了确保安全准确的放射治疗，应选择最佳的计划参数，并在治疗前进行特定于旋转机架角度的验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/e664574e0416/41598_2024_57644_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/2b46d741b84b/41598_2024_57644_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/5c08f6566340/41598_2024_57644_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/9f7a6fc17659/41598_2024_57644_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/43f2dae6d4a6/41598_2024_57644_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/e71bf301f4c0/41598_2024_57644_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/8b622121a41e/41598_2024_57644_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/2e418ee44334/41598_2024_57644_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/e664574e0416/41598_2024_57644_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/2b46d741b84b/41598_2024_57644_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/5c08f6566340/41598_2024_57644_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/9f7a6fc17659/41598_2024_57644_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/43f2dae6d4a6/41598_2024_57644_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/e71bf301f4c0/41598_2024_57644_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/8b622121a41e/41598_2024_57644_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/2e418ee44334/41598_2024_57644_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9d/10965989/e664574e0416/41598_2024_57644_Fig8_HTML.jpg

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