Quantification of proton dose calculation accuracy in the lung.
Quantification of proton dose calculation accuracy in the lung.
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DOI：
10.1016/j.ijrobp.2014.02.023
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发表时间：
2014-06-01
影响因子：
7
通讯作者：
Paganetti, Harald
中科院分区：
文献类型：
--
作者：
Grassberger, Clemens;Daartz, Juliane;Dowdell, Stephen;Ruggieri, Thomas;Sharp, Greg;Paganetti, Harald
通过测量量化临床质子治疗计划系统(TPS)以及基于蒙特卡罗(MC)的剂量计算的准确性。评估一组肺部肿瘤患者的临床影响。使用肺模体和电离室阵列测量通过肺内肿瘤平面的剂量，并确定质子束远端的下落。计算结果与TPS和MC计算结果进行了比较。用MC模拟了19例患者共54个野的剂量分布，并与TPS算法进行了比较。与TPS相比，MC提高了肺组织中剂量计算的准确性，并将靶区的剂量测量结果重现到±2%以内。在穿过靶心的平面上，TPS的实测值与预测值的平均偏差为5.6%，MC的预测值与实测值的平均偏差为1.6%。患者的MC重新计算显示，临床靶区体积的平均剂量比TPS低3.4%，小视野超过5%。对于大的肿瘤，MC也预测正常肺的V5和V10持续较高，这是由于更宽的外侧半影区，这也是实验观察到的。位于靶点远端的关键结构可以显示出很大的偏差，尽管这种影响是患者特有的。距离测量表明，MC可以将距离不确定度降低~2倍：MC与测量范围的平均(最大)差为3.9 mm(7.5 mm)，肺组织TPS的平均(最大)差为7 mm(17 Mm)。将蒙特卡罗剂量计算技术应用于临床，可避免系统性高估靶区剂量和低估正常肺的剂量，从而提高肺癌质子治疗的质量。此外，自信地降低射程范围的能力将通过潜在的较低毒性使所有患者受益。
Quantify the accuracy of a clinical proton treatment planning system (TPS) as well as Monte Carlo (MC) based dose calculation through measurements. Assess the clinical impact in a cohort of patients with tumors located in the lung. A lung phantom and ion chamber array were used to measure the dose to a plane through a tumor embedded in lung and to determine the distal fall-off of the proton beam. Results were compared with TPS and MC calculations. Dose distributions in 19 patients (54 fields total) were simulated using MC and compared to the TPS algorithm. MC increases dose calculation accuracy in lung tissue compared to the TPS and reproduces dose measurements in the target to within ±2%. The average difference between measured and predicted dose in a plane through the center of the target is 5.6% for the TPS and 1.6% for MC. MC recalculations in patients show a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. For large tumors MC also predicts consistently higher V5 and V10 to the normal lung, due to a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target can show large deviations, though this effect is very patient-specific. Range measurements show that MC can reduce range uncertainty by a factor ~2: the average(maximum) difference to the measured range is 3.9mm(7.5mm) for MC and 7mm(17mm) for the TPS in lung tissue. Integration of Monte Carlo dose calculation techniques into the clinic would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. Additionally, the ability to confidently reduce range margins would benefit all patients through potentially lower toxicity.
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DOI：
10.1016/j.ijrobp.2006.01.052
发表时间：
2006-07-15
影响因子：
7
作者：
Chang, Joe Y.;Zhang, Xiaodong;Cox, James D.
通讯作者：
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影响因子：
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作者：
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发表时间：
2007-03-01
影响因子：
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作者：
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通讯作者：
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影响因子：
11.2
作者：
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影响因子：
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作者：
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