ONLINE ADAPTIVE REPLANNING METHOD FOR PROSTATE RADIOTHERAPY
ONLINE ADAPTIVE REPLANNING METHOD FOR PROSTATE RADIOTHERAPY
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DOI：
10.1016/j.ijrobp.2009.10.013
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发表时间：
2010-08-01
影响因子：
7
通讯作者：
Li, X. Allen
中科院分区：
文献类型：
--
作者：
Ahunbay, Ergun E.;Peng, Cheng;Li, X. Allen
目的：报告一种用于前列腺癌放射治疗(RT)的自适应重计划技术，该技术包括两个步骤：(1)分段孔径变形(SAM)和(2)分段权重优化(SWO)，以考虑分段间差异。方法与材料：将新的“SAM+SWO”方案应用于10例前列腺癌患者在直线加速器和CT-on-Rail组合上获得的每日CT图像。将基于每日CT图像的SAM+SWO方案产生的剂量与使用当前计划的目标体积(PTV)边缘(5 mm，离直肠3 mm)和减少的边缘(2 Mm)以及基于每日CT图像的完全再优化扫描重新定位后产生的剂量进行比较，以评估剂量学益处。结果：在所有研究的病例中，与减少PTV的重新定位(最小前列腺癌剂量增加13%)和改善器官保留相比，在线重新计划方法提供了显著更好的靶区覆盖(与常规PTV重新定位相比，直肠的一般等效均匀剂量减少了13%)。完成在线重新计划过程所需的时间为62分钟。结论：所提出的在线重新计划方法可以在实际可接受的时间范围内(5-10分钟)考虑前列腺放射治疗的部分间差异，并且具有显著的剂量学效益。在这项研究的基础上，开发的在线重新规划方案正在临床上实施前列腺放射治疗。(C)2010年爱思唯尔公司。
PurposeZ To report the application of an adaptive replanning technique for prostate cancer radiotherapy (RT), consisting of two steps: (I) segment aperture morphing (SAM), and (2) segment weight optimization (SWO), to account for interfraction variations.Methods and Materials: The new "SAM+SWO" scheme was retroactively applied to the daily CT images acquired for 10 prostate cancer patients on a linear accelerator and CT-on-Rails combination during the course of RT. Doses generated by the SAM+SWO scheme based on the daily CT images were compared with doses generated after patient repositioning using the current planning target volume (PTV) margin (5 mm, 3 mm toward rectum) and a reduced margin (2 mm), along with full reoptimization scans based on the daily CT images to evaluate dosimetry benefits.Results: For all cases studied, the online replanning method provided significantly better target coverage when compared with repositioning with reduced PTV (13% increase in minimum prostate dose) and improved organ sparing when compared with repositioning with regular PTV (13% decrease in the generalized equivalent uniform dose of rectum). The time required to complete the online replanning process was 6 2 minutes.Conclusion: The proposed online replanning method can be used to account for interfraction variations for prostate RT with a practically acceptable time frame (5-10 min) and with significant dosimetric benefits. On the basis of this study, the developed online replanning scheme is being implemented in the clinic for prostate RT. (C) 2010 Elsevier Inc.