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題名:EVALUATE THE ACCURACY OF VMAT FOR CLINICAL USE-THE INITIAL EXPERIENCE OF SMARTARC APPLICATION     (24點)
弧形治療技術於臨床應用之準確度評估-SmartArc初始使用經驗
著者:Su-Hua Lo(羅素花) ;Yu-Wen Wang(王裕文) ;Cyong-Lian Guo(郭瓊蓮) ;Ching-Yu Chang(張瀞予) ;Sung-Wei Lee(李淞維)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:弧形治療 ; 旋轉機頭角度間距 ; Gafchromic EBT2底片 ; 加碼指標通過率 ; VMAT ; Gantry spacing ; Gafchromic EBT2 film ; Gamma passing rate
刊名:Therapeutic Radiology and Oncology
頁碼:131-142
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:本研究的目的在評估SmartArc內不同計算參數設定對弧形治療準確度的影響,我們希望能由數個不同患部的治療計畫中,分別以不同旋轉機頭角度間距運算及是否考量治療床衰減等,實際量測治療之準確度差異。 材料與方法:共選擇28例弧形治療病患,其中包含8例腹部/骨盆、6例單側頭頸部、8例雙側頭頸部及6例攝護腺。使用Elekta Synergy直線加速器及Philips Pinnacle 9.0之SmartArc運算程式執行治療及運算,分別以旋轉機頭角度間距2、3、4及6度執行最佳化計算,並於每組影像加上寬50 cm厚8 mm密度1g/cm3的模擬治療床。照射時,假體內同時擺放0.125 cm3 Semiflex游離腔及Gafchromic EBT2底片。 結果:於所有224個治療計畫中考量有/無治療床差異,符合點劑量±3%基準內之比率分別為99.1%及94.6%;EBT2底片絕對劑量分佈於3%/3 mm的加碼指標通過率,低於95%閾值比率分別為5.4%及11.6%。針對臨床使用參數設定條件(角度間距3度、考量治療床衰減),腹部/骨盆、單側頭頸部、雙側頭頸部、攝護腺於3%/3 mm的加碼指標通過率分別為98.3±2.3%、99.5±0.5%、97.6±2.3%及99.5±0.5%。Kruskal-Wallis H檢定顯示2-6度角度間距之劑量實測結果,並無顯著差異且未達要求案例隨機發生在任何角度間距;Mann-Whitney U檢定顯示,攝護腺以外之其他患部在有/無治療床之p值低於或接近顯著水準。Spearman's correlation coefficient更指出照射MU量可能影響治療準確度(p<0.05)但與PTV大小則無相關性。 結論:利用EBT2底片執行弧形治療前之整體劑量評估確為一可行方法,本研究結果顯示,雖然在不同計算參數設定下治療準確度差異不一,但整體來說,其劑量測量值與計算值之一致性極高。
Purpose: The goal of this study was to investigate the accuracy of VMAT with different calculation parameters in SmartArc. Dosimetric comparisons of various gantry spacings with and without couch (WC/WOC) insert simulation were evaluated based on statistics. Materials and Methods: Twenty-eight VMAT cases were selected in this study, including 8 abdomen/pelvis, 6 one-side HN, 8 two-side HN and 6 prostate. A commercial Elekta Synergy linear accelerator and SmartArc algorithm in Pinnacle3 9.0 was used. The patients were treated clinically with VMAT using 3° gantry spacing and reop-timized using 2°, 4° and 6°. An 8 mm thick water equivalent contour couch was added under the phantom. The phantom was irradiated with 0.125 cm3 Semiflex chamber and Gafchromic EBT2 film simultaneously. Results: 99.1% and 94.6% of WC and WOC passed the 3% point dose difference criteria. In absolute dosimetric agreement of EBT2 film, the gamma passing rate of 3%/3 mm for all 224 plans separately were 5.4% for WC and 11.6% for WOC below 95% tolerance level. While using clinical parameters (3° gantry spacing, WC), the 3%/3 mm gamma average passing rate was 98.3±2.3%, 99.5±0.5%, 97.6±2.8% and 99.5±0.5% for abdomen/pelvis, one-side HN, two-side HN and prostate respectively. Considered with the 2-6° gantry spacing, the Kruskal-Wallis H test shows very similar results and failures situations occurred randomly on any gantry spacing. The results of with/without couch insert simulation shows the Mann-Whitney U test p-value lower than or close to, the significant level expected for prostate cases. Spearman's correlation coefficient indicates that delivery MU may influence the accuracy (p-value <0.05) but it's independent of PTV volume. Conclusions: Composite dose measurements performed with EBT2 film are a practicable approach for patient-specific QA of VMAT plans. Film dosimetry in this study has shown good agreement in various parameter settings.


    

本卷期目次
Therapeutic Radiology and Oncology
COMPARING STEREOTACTIC BODY RADIOTHERAPY WITH THREE-DIMENSIONAL CONFORMAL RADIOTHERAPY FOR PATIENTS WITH UNRESECTABLE OR RECURRENT HEPATOCELLULAR CARCINOMA/ Jang-Chun LinYee-Min JenWen-Yen HuangChang-Min ChenHsing-Lung ChaoChun-Shun LinYu-Fu SuKuen-Tze LinWei-Yuan NienMiao-Jung Lin
TREATMENT OUTCOMES FOR SYNCHRONOUS OR METACHRONOUS HYPOPHARYNGEAL/LARYNGEAL/OROPHARYNGEAL CANCER AND ESOPHAGEAL CANCER/ Che-Yu HsuJason Chia-Hsien ChengSung-Hsin KuoYu-Hsuan ChenChiao-Ling TsaiKeng-Hsueh LanWan-Yu ChenChun-Wei Wang
EVALUATE THE ACCURACY OF VMAT FOR CLINICAL USE-THE INITIAL EXPERIENCE OF SMARTARC APPLICATION/ Su-Hua LoYu-Wen WangCyong-Lian GuoChing-Yu ChangSung-Wei Lee
IMPROVEMENT OF SETUP ACCURACY BY NECK-SHOULDER BAG DURING RADIOTHERAPY IN HEAD AND NECK CANCER PATIENTS/ Pei-Hua FanChen-Yuan ChenYi-Chen LiuShiue-Shiun ChenYen-Chao ChenChieh-Sheng TsaiJih-Hong HongWai-Man Leung
SIMULTANEOUS INTEGRATED BOOST INTENSITY-MODULATED RADIOTHERAPY FOR LOCALLY ADVANCED ANAPLASTIC THYROID CANCER/ Yu-Ming WangChun-Chieh HuangHui-Min TingChong-Jong Wang
OSTEOSARCOMA AFTER IRRADIATED NASOPHARYNGEAL CARCINOMA: A CASE REPORT/ I-Chun YehMing-Yang LeeJenn-Ren HsiaoSen-Tien TsaiHelen H. W. ChenJin-Ching Lin
EVALUATION OF LUNG VOLUME/DOSE IN BREAST CANCER IRRADIATION AFTER MODIFIED RADICAL MASTECTOMY VERSUS BREAST CONSERVATIVE SURGERY/ Li-Min SunJi-An LiangFan-Yun MengTsung-Han YangMin-Jen Tsao
CLINICAL CHARACTERISTICS, IMAGE FINDINGS, AND TREATMENT MODALITIES ASSOCIATE WITH OUTCOMES OF PATIENTS WITH GLIOBLASTOMA MULTIFORME/ Hsiang-Kuang LiangChao-Yuan HuangChun-Wei WangYu-Hsuan ChenSung-Hsin KuoJason Chia-Hsien Cheng
 
   
 
   

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