Dose assessment for patients with stage I non-small cell lung cancer receiving passive scattering carbon-ion radiotherapy using daily computed tomographic images: A prospective study
Dose assessment for patients with stage I non-small cell lung cancer receiving passive scattering carbon-ion radiotherapy using daily computed tomographic images: A prospective study
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DOI：
10.1016/j.radonc.2020.01.003
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发表时间：
2020-03-01
影响因子：
5.7
通讯作者：
Ohno, Tatsuya
中科院分区：
文献类型：
--
作者：
Li, Yang;Kubota, Yoshiki;Ohno, Tatsuya
背景和目的：本研究的目的是评估剂量分布与被动散射碳离子放射治疗（C-离子RT）使用每日计算机断层扫描（CT）images.Materials和方法：我们招募了10例I期非小细胞肺癌（NSCLC），并获得了共40 prefractional CT图像系列在相同的设置下的规划CT images. Materials。使用骨匹配（BM）和肿瘤匹配（TM）将这些CT图像与计划CT图像配准以进行剂量评估。使用可变形图像配准，我们生成累积剂量。此外，体积剂量参数进行了比较，在肿瘤覆盖和肺暴露和统计分析performed.Results：总体而言，25%的40个分数的剂量分布是不可接受的BM，与TM的2.5%相比（P < 0.001）。使用BM，3名患者的累积剂量分布不可接受;然而，使用TM，所有患者均满意（P < 0.001）。水等效路径长度（WEL）没有观察到差异。剂量分布差的患者所需的利润率分别为5.9和4.4 mm BM和TM，force.Conclusions：本研究建立了CT图像为基础的TM是强大的，与传统的BM相比，每日和累积剂量分布。WEL变化的影响似乎是有限的。因此，对于接受C离子RT的I期NSCLC患者，建议每日CT对齐。（C）2020作者。由爱思唯尔公司出版
Background and purpose: This study aimed to assess dose distributions for stage I non-small cell lung cancer (NSCLC) with passive scattering carbon-ion radiotherapy (C-ion RT) using daily computed tomography (CT) images.Materials and methods: We enrolled 10 patients with stage I NSCLC and acquired a total of 40 prefractional CT image series under the same settings as the planning CT images. These CT images were registered with planning CT images for dose evaluation using both bone matching (BM) and tumor matching (TM). Using deformable image registration, we generated accumulated doses. Moreover, the volumetric dose parameters were compared in terms of tumor coverage and lung exposure and statistical analyses were performed.Results: Overall, 25% of 40 fractional dose distributions were unacceptable with BM, compared with 2.5% with TM (P < 0.001). Using BM, three patients' accumulated dose distributions were unacceptable; however, all were satisfactory with TM (P < 0.001). No differences were observed in water-equivalent path length (WEL). The required margins in patients with poor dose distribution were 5.9 and 4.4 mm for BM and TM, respectively.Conclusions: This study establishes that CT image-based TM is robust compared with conventional BM for both daily and accumulated dose distributions. The effects of changes in WEL seem to be limited. Hence, daily CT alignment is recommended for patients with stage I NSCLC receiving C-ion RT. (C) 2020 The Author(s). Published by Elsevier B.V.