A Fully Independent Real Time Treatment Verification System for Radiotherapy

 描述(由申请人提供)：现代放射治疗已经发展到了复杂的程度，以至于重大的治疗错误既很难发现，也很难完全避免。在当今的放射治疗科室中，大量患者接受调强放射治疗(IMRT)是很常见的。当使用这些技术治疗患者时，可能很难检测到患者设置错误和 如果不使用自动二次检查，几乎不可能检测到光束准直误差。不正确的剂量传递或剂量传递到错误的区域也是持续的治疗风险。尽管在实施检测差错的自动化机制方面取得了进展，但有关治疗失误的发生率仍然很高。据几位作者报道，现代的治疗错误发生在患者治疗过程中的1%到2%。虽然其中大多数被判断为不具有临床重要性，但仅在美国，重大治疗差错的比率仍然是每年数千起。折衷的放射治疗可能导致较低的控制率和/或较高的并发症发生率。我们将开发一种系统，使放射治疗临床能够在患者接受任意复杂的治疗技术治疗时，实时地完整和独立地测量个人治疗部分的几何排列和剂量顺应性。该系统将包括一个高密度的辐射探测器斗篷，部署在以治疗设备等中心为中心的环形中，并在辐射传输系统头部(S)的旋转圆内。探测器斗篷将包围正在接受治疗的患者的区域，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学数据将允许计算实际提供给 每一次治疗过程中的病人。该检测系统将在物理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著减少放射治疗差错。减少治疗失误可以增加局部肿瘤控制率，减少治疗并发症的发生率，或者两者兼而有之。正在进行的实际治疗提供遵从性数据的汇编将是对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.