Dose escalation in the definite target volume.
Dose escalation in the definite target volume.
复制标题
确定目标体积的剂量升级。
DOI：
10.1002/mp.14164
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发表时间：
2020-07
期刊：
影响因子：
3.8
通讯作者：
Siebers JV
中科院分区：
文献类型：
--
作者：
Watkins WT;Nourzadeh H;Siebers JV
介绍明确靶体积 (DTV) 并评估在高临床靶体积 (CTV) 和低危器官 (OAR) 概率区域增加剂量的剂量测定结果。这项工作通过占用概率和通过边际 M 减去任何规划风险量 (PRV) 量来收缩 CTV 来定义 DTV。对于球形目标体积，建立了两种方法在不同占用概率内的等效性。我们根据利用重复体积成像的现代图像引导放射治疗文献估计了四个放射治疗部位的余量。根据裕度和患者特定的 DTV 目标，评估了 DTV 剂量升级的能力，包括空间不确定性的影响。我们假设违反 130% 的潜在空间不确定性来模拟交付。将规划目标体积 (PTV) 缩小为 M 并排除 PRV 体积，DTV 范围为 7.3 至 93.6 cc。在脑部治疗中，DTV-Dmax 增加至 66.8 Gy（处方等剂量的 145%）；在晚期肺部 DTV-Dmax 增加至 122.2 Gy（处方等剂量的 204%），在胰腺病例中 DTV-Dmax 增加至 87.3 Gy（173% 或处方等剂量），在腹膜后肉瘤中增加至 74.6 Gy（处方等剂量的 249%）。即使考虑到空间不确定性的影响，高点剂量也与 OAR 剂量增加无关。在假设空间不确定性的 130% 下模拟分娩表明，在胰腺病例中，基于 DTV 的计划可导致 OAR Dmean/Dmax 轻微增加 2.7 ± 2.1 Gy/1.8 ± 2.2 Gy，且十二指肠 Dmax > 处方等剂量的 110%。这些剂量增加与临床同质 PTV 剂量分布的模拟一致。我们提出并测试了一种方法，通过定义新的目标体积 DTV，向多个治疗部位的目标体积的子体积提供极高的剂量。基于模拟递送，如果可以估计空间不确定性，该方法不会导致 OAR 剂量显着增加。
To introduce the definite target volume (DTV) and evaluate dosimetric consequences of boosting dose to this region of high clinical target volume (CTV)- and low organs at risk (OAR)-probability. This work defines the DTV via occupancy probability and via contraction of the CTV by margin M less any planning risk volume (PRV) volumes. The equivalence to within varying occupancy probability of the two methods is established for spherical target volumes. We estimate a margin for four radiation treatment sites based on modern images guided radiation therapy-literature utilizing repeat volumetric imaging. Based on margins and patient-specific DTV targets, the ability to dose escalate the DTV including the effects of spatial uncertainty was evaluated. We simulate delivery assuming violation of the underlying spatial uncertainty of 130%. Contracting the planning target volume (PTV) by M and excluding PRV volumes, the DTV ranged from 7.3 to 93.6 cc. In a brain treatment, DTV-Dmax increased to 66.8 Gy (145% of prescription isodose); in advanced lung DTV-Dmax increased to 122.2 Gy (204% of prescription isodose), in a pancreatic case DTV-Dmax was boosted up to 87.3 Gy (173% or prescription isodose), and in retroperitoneal sarcoma to 74.6 Gy (249% of prescription isodose). The high point doses were not associated with increased dose to OARs, even when considering the effects of spatial uncertainty. Simulated delivery at 130% of assumed spatial uncertainties revealed DTV-based planning can result in minor increases in OAR Dmean/Dmax of 2.7 ± 2.1 Gy/1.8 ± 2.2 Gy with duodenum Dmax > 110% of prescription isodose in the pancreatic case. These dose increases were consistent with simulation of clinical, homogenous PTV-dose distributions. We have proposed and tested a method to deliver extremely high doses to subvolumes of target volumes in multiple treatment sites by defining a new target volume, the DTV. Based on simulated delivery, the method does not result in significant increases in dose to OARs if spatial uncertainty can be estimated.
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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：
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作者：
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DOI：
10.1016/j.ijrobp.2005.02.011
发表时间：
2005-06-01
影响因子：
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作者：
Schwarz, M;Alber, M;Damen, EMF
通讯作者：
Damen, EMF