A multi-institutional study of secondary check of treatment planning using Clarkson-based dose calculation for three-dimensional radiotherapy
A multi-institutional study of secondary check of treatment planning using Clarkson-based dose calculation for three-dimensional radiotherapy
复制标题
DOI：
10.1016/j.ejmp.2018.04.394
复制
发表时间：
2018-05-01
影响因子：
3.4
通讯作者：
Tachibana, Hidenobu
中科院分区：
文献类型：
--
作者：
Takahashi, Ryo;Kamima, Tatsuya;Tachibana, Hidenobu
目的：由于很少有关于独立监测单位（MU）验证的机构间结果定量分析的报道，我们进行了一项多机构验证研究，以显示应用美国和欧洲使用的3-5%行动水平的可行性，并显示机构间比较的结果。方法：收集12所机构5936个调查领域。在对测量和软件比较进行验证研究后，我们使用了采用克拉克森算法的商业软件进行验证。使用验证软件对治疗计划系统（tps）产生的剂量进行回顾性分析。结果：所有地点的平均±两个标准差为1.0±3.6%。乳腺（4.0 +/- 4.0%）和肺（2.5 +/- 5.8%）的差异更大。在作用水平差异超过5%的领域中，有80%涉及乳房和肺部目标，有7.2 +/- 5.4%。机构间比较显示，乳腺场形状的各种系统差异，场的差异可归因于肺参考点放置的差异。乳房和肺部的巨大差异部分可归因于用于纠正异质性的方法的差异。结论：5%的行动水平是可行的；然而，在临床实践中，了解乳腺和肺计划的较大差异是很重要的。在机构间比较的基础上，从具有不同实地形态背景和不正确放置参考点的计划中确定具体机构的行动水平时，必须谨慎。
Purpose: As there have been few reports on quantitative analysis of inter-institutional results for independent monitor unit (MU) verification, we performed a multi-institutional study of verification to show the feasibility of applying the 3-5% action levels used in the U.S. and Europe, and also to show the results of inter-institutional comparisons.Methods: A total of 5936 fields were collected from 12 institutions. We used commercial software employing the Clarkson algorithm for verification after a validation study of measurement and software comparisons was performed. The doses generated by the treatment planning systems (TPSs) were retrospectively analyzed using the verification software.Results: Mean +/- two standard deviations of all locations were 1.0 +/- 3.6%. There were larger differences for breast (4.0 +/- 4.0%) and for lung (2.5 +/- 5.8%). A total of 80% of the fields with differences over 5% of the action level involved breast and lung targets, with 7.2 +/- 5.4%. Inter-institutional comparisons showed various systematic differences for field shape for breast and differences in the fields were attributable to differences in reference point placement for lung. The large differences for breast and lung are partially attributable to differences in the methods used to correct for heterogeneity.Conclusions: The 5% action level may be feasible for verification; however, an understanding of larger differences in breast and lung plans is important in clinical practice. Based on the inter-institutional comparisons, care must be taken when determining an institution-specific action level from plans with different field shape settings and incorrectly placed reference points.