Dosimetric effects of intrafractional isocenter variation during deep inspiration breath-hold for breast cancer patients using surface-guided radiotherapy.
Dosimetric effects of intrafractional isocenter variation during deep inspiration breath-hold for breast cancer patients using surface-guided radiotherapy.
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DOI：
10.1002/acm2.12214
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发表时间：
2018-01
影响因子：
2.1
通讯作者：
Ceberg S
中科院分区：
文献类型：
--
作者：
Kügele M;Edvardsson A;Berg L;Alkner S;Andersson Ljus C;Ceberg S
本研究的目的是研究使用光学表面扫描系统Catalyst™视觉引导深度吸气屏气（DIBH）对左侧乳腺癌患者心脏、左冠状动脉前降支（LAD）和同侧肺的潜在剂量减少，以及屏气之间的牵引内运动如何影响这些潜在的剂量学益处。对于DIBH和自由呼吸（FB），为20名切向性和20名局部区域性左侧乳腺癌患者制定了治疗计划。在DIBH治疗期间，使用3mm的门控窗由剑突上的感兴趣区域触发光束。使用一种新颖的非刚性算法，Catalyst™系统可以同时实时跟踪等心位置，用于计算DIBH内等心再现性。计算了50%和90%的累加概率和DIBH内等中心再现性最大值，并在治疗计划系统中进行相应的等中心移位以获得剂量学效应。对于切向和局部治疗，与FB相比，DIBH对心脏，LAD和同侧肺的剂量显着降低。在大多数治疗过程中，DIBH等中心的再现性非常好，在所有三个平移方向上的中位值约为1毫米。然而，在一些治疗疗程中，观察到屈光度内DIBH等中心可重复性高达5mm，这导致对靶体积和危险器官的大剂量效应。因此，重要的是要设定屈光内等心运动的容忍度，而不仅仅是基于剑突进行DIBH。
The aim of this study was to investigate potential dose reductions to the heart, left anterior descending coronary artery (LAD), and ipsilateral lung for left‐sided breast cancer using visually guided deep inspiration breath‐hold (DIBH) with the optical surface scanning system Catalyst™, and how these potential dosimetric benefits are affected by intrafractional motion in between breath holds. For both DIBH and free breathing (FB), treatment plans were created for 20 tangential and 20 locoregional left‐sided breast cancer patients. During DIBH treatment, beam‐on was triggered by a region of interest on the xiphoid process using a 3 mm gating window. Using a novel nonrigid algorithm, the Catalyst™ system allows for simultaneous real‐time tracking of the isocenter position, which was used to calculate the intrafractional DIBH isocenter reproducibility. The 50% and 90% cumulative probabilities and maximum values of the intrafractional DIBH isocenter reproducibility were calculated and to obtain the dosimetric effect isocenter shifts corresponding to these values were performed in the treatment planning system. For both tangential and locoregional treatment, the dose to the heart, LAD and ipsilateral lung was significantly reduced for DIBH compared to FB. The intrafractional DIBH isocenter reproducibility was very good for the majority of the treatment sessions, with median values of approximately 1 mm in all three translational directions. However, for a few treatment sessions, intrafractional DIBH isocenter reproducibility of up to 5 mm was observed, which resulted in large dosimetric effects on the target volume and organs at risk. Hence, it is of importance to set tolerance levels on the intrafractional isocenter motion and not only perform DIBH based on the xiphoid process.
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影响因子：
158.5
作者：
Darby, Sarah C.;Ewertz, Marianne;Hall, Per
通讯作者：
Hall, Per
使用催化剂（TM）/Sentinel（TM）系统对左侧乳腺癌患者进行封闭式放疗的治疗计划和评估，以进行深度灵感呼吸（DIBH）。
DOI：
10.1186/s13014-016-0716-5
发表时间：
2016-10-26
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Schönecker S;Walter F;Freislederer P;Marisch C;Scheithauer H;Harbeck N;Corradini S;Belka C
通讯作者：
Belka C
影响因子：
2.1
作者：
Tang, Xiaoli;Cullip, Tim;Marks, Lawrence
通讯作者：
Marks, Lawrence
DOI：
10.1016/j.ijrobp.2015.06.010
发表时间：
2015-11-15
影响因子：
7
作者：
Wiant, David;Wentworth, Stacy;Sintay, Benjamin
通讯作者：
Sintay, Benjamin
影响因子：
51.1
作者：
Darby, SC;McGale, P;Peto, R
通讯作者：
Peto, R