CAJ | 학술논문

目的探索Compass(R)三维QC系统在食管癌调强放疗剂量验证中的应用.方法选取12例食管癌病例在Eclipse 8.6治疗计划系统中进行优化设计,将计划分别传入Compass(R)系统和瓦里安Trilogy加速器.Compass(R)在患者解剖影像上重建三维剂量分布,将重建剂量与治疗计划系统计算剂量比较,验证PTV及各OAR体积γ通过率、Dmean偏差等参数.同时使用MatriXX对治疗计划做二维剂量验证,使用平面γ通过率(3％/3 mm)评估剂量验证结果.结果二维剂量验证实际角度γ通过率普遍低于角度归零的γ通过率(P =0.018 ～0.001).三维剂量验证PTV体积γ通过率＞93％,D95％、D50％、D2％偏离＜3％;肺和心脏体积γ通过率＞95％,Dmean偏离＞3％;脊髓和气管体积γ通过率＞98％.独立计算与TPS计算剂量有更好符合度,测量重建与TPS计算剂量偏差出现在射野边缘区域.结论三维剂量验证可提供更多的信息全面来评价计划,对指导治疗更有意义.
목적 탐색Compass(R)삼유QC계통재식관암조강방료제량험증중적응용.방법 선취12례식관암병례재Eclipse 8.6치료계화계통중진행우화설계,장계화분별전입Compass(R)계통화와리안Trilogy가속기.Compass(R)재환자해부영상상중건삼유제량분포,장중건제량여치료계화계통계산제량비교,험증PTV급각OAR체적γ통과솔、Dmean편차등삼수.동시사용MatriXX대치료계화주이유제량험증,사용평면γ통과솔(3％/3 mm)평고제량험증결과.결과 이유제량험증실제각도γ통과솔보편저우각도귀령적γ통과솔(P =0.018 ～0.001).삼유제량험증PTV체적γ통과솔＞93％,D95％、D50％、D2％편리＜3％;폐화심장체적γ통과솔＞95％,Dmean편리＞3％;척수화기관체적γ통과솔＞98％.독립계산여TPS계산제량유경호부합도,측량중건여TPS계산제량편차출현재사야변연구역.결론 삼유제량험증가제공경다적신식전면래평개계화,대지도치료경유의의.
Objective To study the clinical application of Compass (R) system,a novel 3D quality assurance system for the verification of esophageal carcinoma intensity-modulated radiotherapy (IMRT) plan.Methods 12 esophageal carcinoma IMRT plans were optimized with Eclipse 8.6 treatment planning system (TPS),and then Compass (R) reconstructed 3D dose distributions with the patient anatomy.Comparison was performed among the reconstructed and calculated with TPS,Dose-volume parameters (γ pass rate、average dose deviation) to the planning target volume (PTV) and critical structures were quantitative valuated.Furthermore two-dimensional dose verification were performed use MatriXX,γ pass rate were evaluated with 3％/3 mm criteria.Results The γ pass rate of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle in two dimensional verification,difference was statistically significant (P =0.018-0.001).In 3D dose verification,the γvolume of PTV were exceed 93％,the deviation of D95,D50,D2 were less than 3％;The γvolume of lungs and heart were exceed 95％,the average dose deviation were less than 3％;The γ pass rate of spinal cord and trachea were exceed 98％.The independent check verified more conformed with the TPS calculated.Dose deviations appeared in the radiation field edge area.Conclusions 3D dose verification can provide more information to comprehensively evaluate the plan which is benefit for evaluating the clinical value of verification.