Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor
Four-dimensional treatment planning and fluoroscopic real-time tumor tracking radiotherapy for moving tumor
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DOI：
10.1016/s0360-3016(00)00625-8
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发表时间：
2000-09-01
影响因子：
7
通讯作者：
Miyasaka, K
中科院分区：
文献类型：
--
作者：
Shirato, H;Shimizu, S;Miyasaka, K
目的：为了实现移动肿瘤的精确三维（3D）适形放疗，开发了一种新型放疗系统及其治疗计划系统并用于临床实践。方法和材料：我们开发了与透视实时肿瘤跟踪系统同步的直线加速器，每0.03秒可以确定肿瘤中2.0毫米金标记的3D坐标，并确定肿瘤之间的3D关系。 使用每个呼吸阶段的 CT 图像评估不同呼吸阶段的标记物和肿瘤，从而可以选择最佳阶段以与照射同步（4D 治疗计划）。仅当标记物位于相对于等中心点的计划坐标区域内时，直线加速器才会被触发照射肿瘤。结果：在体模实验中的放射治疗过程中，以+/-1毫米的精度检测到标记物的坐标。识别标记位置与开始或停止兆伏X射线照射之间的时间延迟为0.03秒。 14名不同肿瘤的患者接受了“紧”计划靶区（PTV）边缘的适形放疗，中位随访6个月，他们均存活下来，没有复发或并发症。 结论：开发了遵循4D治疗计划的透视实时肿瘤跟踪放疗，并证明是可行的，可提高移动肿瘤放疗的准确性。 (C) 2000 爱思唯尔科学公司。
Purpose: To achieve precise three-dimensional (3D) conformal radiotherapy for mobile tumors, a new radiotherapy system and its treatment planning system were developed and used for clinical practice.Methods and Materials: We developed a linear accelerator synchronized with a fluoroscopic real-time tumor tracking system by which 3D coordinates of a 2.0-mm gold marker in the tumor can be determined every 0.03 second, The 3D relationships between the marker and the tumor at different respiratory phases are evaluated using CT image at each respiratory phase, whereby the optimum phase can be selected to synchronize with irradiation (4D treatment planning). The linac is triggered to irradiate the tumor only when the marker is located within the region of the planned coordinates relative to the isocenter.Results: The coordinates of the marker were detected with an accuracy of +/- 1 mm during radiotherapy in the phantom experiment. The time delay between recognition of the marker position and the start or stop of megavoltage X-ray irradiation was 0.03 second. Fourteen patients with various tumors were treated by conformal radiotherapy with a "tight" planning target volume (PTV) margin, They were surviving without relapse or complications with a median follow-up of 6 months.Conclusion: Fluoroscopic real-time tumor tracking radiotherapy following 4D treatment planning was developed and shown to be feasible to improve the accuracy of the radiotherapy for mobile tumors. (C) 2000 Elsevier Science Inc.