A Fully Independent Real Time Treatment Verification System for Radiotherapy

 描述（由申请人提供）：现代放射治疗的复杂性已经发展到很难发现和完全避免重大治疗错误的程度。在当今的放射治疗部门中，通常有大量患者用强度调制放射治疗（IMRT）技术进行治疗。当用这些技术治疗患者时，可能难以检测患者设置错误， 实际上不可能在不使用自动二次检查的情况下检测光束准直误差。不正确的剂量输送或输送到错误区域的剂量也是一种持续的治疗风险。尽管在实施自动化错误检测机制方面取得了进展，但有关治疗不当的发生率仍然很高。几位作者报告称，在现代，1%至2%的患者治疗过程中发生治疗输送错误。虽然大多数这些被认为不具有临床重要性，但仅在美国，重大治疗错误的发生率仍为每亚尔年数千起。放射治疗受损可能导致控制率降低和/或并发症发生率升高。我们将开发一个系统，该系统将为放射治疗诊所提供在患者接受任何任意复杂的治疗技术治疗时，完全独立地测量真实的时间内单个治疗部分的几何对准和剂量测定依从性的能力。该系统将由辐射探测器的高密度斗篷组成，辐射探测器部署在以治疗设备等中心为中心的环中，并位于辐射输送系统头部的旋转圆内。探测器斗篷将围绕患者体内接受治疗的区域，并将测量进入和离开患者的辐射通量。在治疗时获得的剂量测定数据将允许计算实际输送到的完整剂量分布。 患者的每一次治疗。检测系统将在物理上和电子上独立于治疗系统，从而提供对输送剂量的真正全面的二级监测。开发和临床部署一个完全独立的放射治疗验证系统，有可能显着减少放射治疗错误。治疗递送错误的减少可以提高局部肿瘤控制率，降低治疗并发症的发生率或两者兼而有之。正在进行的实际治疗提供依从性数据的汇编将作为新实施的质量保证技术的益处或缺乏益处的宝贵确认。

 DESCRIPTION (provided by applicant): Modern day radiotherapy has developed in complexity to the degree that significant treatment errors are both difficult to detect and difficut to completely avoid. In the current day radiotherapy department it is common to have a large number of patients being treated with Intensity Modulated Radiotherapy (IMRT) techniques. When treating patients with these techniques it can be difficult to detect patient setup errors and virtually impossible to detect beam collimation errors without the use of automated secondary checks. Incorrect dose delivery or dose delivered to the wrong area is also an ongoing treatment risk. Despite gains in the implementation of automated mechanisms for detection of errors the incidence of concerning treatment misadministrations is still significant. Treatment delivery errors in the modern era have been reported by several authors as occurring during from 1 to 2 % of patients' courses of treatment. While most of these are judged to not be of clinical importance, the rate of significant treatment errors is still thousands of incidents per yar in the United States alone. Compromised radiotherapy treatments can lead to lower control rates and/or higher complication rates. We will develop a system that will provide the radiotherapy clinic with the capability to completely and independently measure the geometric alignment and dosimetric compliance of an individual treatment fraction in real time as the patient is treated with any arbitrarily complex treatment technique. The system will consist of a high density cloak of radiation detectors deployed in a ring centered on the treatment apparatus isocenter and within the rotational circle of the head(s) of the radiation delivery system. The detector cloak will surround the area within the patient being treated and will measure the radiation fluence both entering and exiting the patient. The dosimetric data acquired at the time of treatment will allow for the calculation of the complete dose distribution actually delivered to the patient for each and every treatment session. The detection system will be physically and electronically independent of the treatment system thereby providing a truly comprehensive secondary monitor of the delivered dose. Development and clinical deployment of a completely independent treatment verification system for radiotherapy has the potential to significantly reduce radiotherapy treatment errors. The reduction of treatment delivery errors can increase local tumor control rates, reduce the rate of treatment complications or both. The ongoing compilation of actual treatment delivery compliance data will serve as invaluable confirmation of the benefit, or lack thereof, of newly implemented quality assurance techniques.