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Dose Distributions in Simulated Electron Radiotherapy with Intraoral Cones Using Treatment Planning System
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作者 Tomohiro Shimozato Kuniyasu Okudaira 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2017年第3期280-289,共10页
Aim: This study aims to evaluate the difference between depth data from an intraoral cone and a conventional irradiation tube calculated using a treatment planning system (TPS), and that measured using an intraoral co... Aim: This study aims to evaluate the difference between depth data from an intraoral cone and a conventional irradiation tube calculated using a treatment planning system (TPS), and that measured using an intraoral cone for electron radiotherapy. Background: A TPS is only compatible with conventional irradiation tubes. However, such systems are not suitable for determining dose distributions when a special cone is employed. Materials and Methods: Dose distributions were calculated using the beam data for mounted intraoral cones using a TPS. Then, the dose distribution by field size was calculated for a low-melting-point lead alloy using the beam data for a mounted conventional tube. The calculated data were evaluated against the measured intraoral-cone depth data based on the dose and depth differences. Results: The calculated data for the intraoral cone case did not match the measured data. However, the depth data obtained considering the field size determined for the lead alloy using the conventional tube were close to the measured values for the intraoral cone case. The difference in the depth at which the absorbed dose was 50% of the maximum value of the percentage depth dose was less than ±4 mm for the generalized Gaussian pencil beam convolution algorithm and less than ±1 mm for the electron Monte Carlo algorithm. Conclusion: It was found that the measured and calculated dose distributions were in agreement, especially when then electron Monte Carlo algorithm was used. Thus, the TPS can be employed to determine dose distributions for intraoral cone applications. 展开更多
关键词 treatment planning system ELECTRON radiotherapy INTRAORAL CONE Depth DOSE Algorithm
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Complex Target Volume Delineation and Treatment Planning in Radiotherapy for Malignant Pleural Mesothelioma (MPM)
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作者 Aaron Innocent Bogmis Adrian Raducu Popa +4 位作者 Daniela Adam Violeta Ciocâltei Nicoleta Alina Guraliuc Florin Ciubotaru Ion-Christian Chiricuță 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2020年第3期125-140,共16页
<strong>Introduction:</strong> Radiotherapy alone or combined with surgery and/or chemotherapy is being investigated in the treatment of malignant pleural mesothelioma (MPM). This study aimed to simulate a... <strong>Introduction:</strong> Radiotherapy alone or combined with surgery and/or chemotherapy is being investigated in the treatment of malignant pleural mesothelioma (MPM). This study aimed to simulate a Volumetric Modulated Arc Therapy (VMAT) treatment of a patient with MPM. <strong>Materials and Methods:</strong> CT images from a patient with intact lungs were imported via DICOM into the Pinnacle3 treatment planning (TP) system (TPS) and used as a model for MPM to delineate organs at risk (OAR) and both clinical and planning target volumes (CTV and PTV) with a margin of 5 mm. Elekta Synergy with 6 MV photons and 80 leafs MLCi2 was employed. VMAT plans were generated using two coplanar arcs with gantry rotation angles of 178<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">&deg</span> - 182<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">&deg</span>, the collimator angles of each arc were set to 90<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">&deg</span>, Octavius<span style="white-space:nowrap;"><sup>&reg;</sup></span> 4D 729 was employed for quality assurance while the calculated and measured doses were compared using VeriSoft. <strong>Results:</strong> A TP was achieved. The Gamma volume analysis with criteria of 3 mm distance to agreement and 3% dose difference yielded the gamma passing rate = 99.9%. The reference isodose was 42.75 Gy with the coverage constraints for the PTV D95 and V95 = 95.0% of 45 Gy. The remaining dosimetric parameters met the recommendations from the clinically acceptable guidelines for the radiotherapy of MPM. <strong>Conclusion:</strong> Using well-defined TV and VMAT, a consistent TP compared to similar ones from publications was achieved. We obtained a high agreement between the 3D dose reconstructed and the dose calculated. 展开更多
关键词 Malignant Pleural Mesothelioma Radiation Therapy radiotherapy Volumetric Modulated Arc Therapy VMAT Target Volume Delineation treatment planning CTV PTV
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Comparative Study between Field-in-Field and IMRT Techniques in Prostate Cancer Radiotherapy: A Treatment Planning Study
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作者 Tamer Dawod Sabbah I. Hammoury 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2016年第1期18-25,共8页
Introduction: Field-in-Field (FIF) and Intensity Modulated Radiation Therapy (IMRT) are two advanced radiation therapy planning techniques. Both of them are being used to achieve the same two related aims which are, t... Introduction: Field-in-Field (FIF) and Intensity Modulated Radiation Therapy (IMRT) are two advanced radiation therapy planning techniques. Both of them are being used to achieve the same two related aims which are, to expose the targeted tumor to the full radiation dose and to spare the nearby normal tissues (or organs) from being exposed to high amounts of radiation more than its tolerance dose limits. FIF is a forward planning while IMRT is an inverse planning and FIF is a forward IMRT. Aim: The purpose of this study was to compare between Field-in-Field and IMRT techniques in prostate cancer radiotherapy. Method: A treatment planning system supporting both inverse and forward planning facilities is used. Ten prostate cancer patients were planned with both FIF and IMRT planning techniques. Doses received by the Planning Target Volume (PTV) and Organs at Risk (OARs) were compared in the two methods quantitatively from Dose Volume Histograms (DVHs) and qualitatively from (axial cuts). Results: The results showed that the IMRT planning technique achieved better dose coverage to the PTV than the FIF planning technique but, except RT and LT Femoral Heads, FIF achieved a better protection to the Rectum and the Bladder (OARs) than IMRT. Conclusions: The results showed that the inverse planning based IMRT technique is better and recommended in the prostate cancer radiotherapy than the FIF technique. 展开更多
关键词 radiotherapy IMRT FIF Prostate Cancer Linear Accelerator treatment planning system TPS
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Volumetric-modulated arc therapy vs c-IMRT in esophageal cancer:A treatment planning comparison 被引量:36
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作者 Li Yin Hao Wu +8 位作者 Jian Gong Jian-Hao Geng Fan Jiang An-Hui Shi Rong Yu Yong-Heng Li Shu-Kui Han Bo Xu Guang-Ying Zhu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第37期5266-5275,共10页
AIM: To compare the volumetric-modulated arc ther- apy (VMAT) plans with conventional sliding window intensity-modulated radiotherapy (c-IMRT) plans in esophageal cancer (EC). METHODS: Twenty patients with EC ... AIM: To compare the volumetric-modulated arc ther- apy (VMAT) plans with conventional sliding window intensity-modulated radiotherapy (c-IMRT) plans in esophageal cancer (EC). METHODS: Twenty patients with EC were selected, including 5 cases located in the cervical, the upper, the middle and the lower thorax, respectively. Five plans were generated with the eclipse planning sys- tem: three using c-IMRT with 5 fields (5F), 7 fields (7F) and 9 fields (gF), and two using VMAT with a single arc (1A) and double arcs (2A). The treatment plans were designed to deliver a dose of 60 Gy to the plan-ning target volume (PTV) with the same constrains in a 2.0 Gy daily fraction, 5 d a week. Plans were normal- ized to 95% of the PTV that received 100% of the pre- scribed dose. We examined the dose-volume histogram parameters of PTV and the organs at risk (OAR) such as lungs, spinal cord and heart. Monitor units (MU) and normal tissue complication probability (NTCP) of OAR were also reported. RESULTS: Both c-IMRT and VMAT plans resulted in abundant dose coverage of PTV for EC of different Io- cations. The dose conformity to PTV was improved as the number of field in c-IMRT or rotating arc in VMAT was increased. The doses to PTV and OAR in VMAT plans were not statistically different in comparison with c-IMRT plans, with the following exceptions: in cervical and upper thoracic EC, the conformity index (CI) was higher in VMAT (1A 0.78 and 2A 0.8) than in c-IMRT (5F 0.62, 7F 0.66 and 9F 0.73) and homogeneity was slightly better in c-IMRT (7F 1.09 and 9F 1.07) than in VMAT (1A 1,1 and 2A 1.09), Lung V30 was lower in VMAT (1A 12.52 and 2A 12.29) than in c-IMRT (7F 14.35 and 9F 14.81). The humeral head doses were significantly increased in VMAT as against c-IMRT. In the middle and lower thoracic EC, CI in VMAT (1A 0.76 and 2A 0.74) was higher than in c-IMRT (5F 0.63 Gy and 7F 0.67 Gy), and homogeneity was almost similar between VMAT and c-IMRT. V20 (2A 21.49 Gy vs 7F 24.59 Gy and 9F 24.16 Gy) and V30 (2A 9.73 Gy vs 5F 12.61 Gy, 7F 11.5 Gy and 9F 11.37 Gy) of lungs in VMAT were lower than in c-IMRT, but low doses to lungs (V5 and Vl0) were increased. V30 (1A 48.12 Gy vs 5F 59.2 Gy, 7F 58.59 Gy and 9F 57.2 Gy), V40 and V50 of heart in VMAT was lower than in c-IMRT. MUs in VMAT plans were significantly reduced in comparison with c-IMRT, maximum doses to the spinal cord and mean doses of lungs were similar between the two techniques. NTCP of spinal cord was 0 for all cases. NTCP of lungs and heart in VMAT were lower than in c-IMRT. The advantage of VMAT plan was enhanced by doubling the arc. CONCLUSION: Compared with c-IMRT, VMAT, especial- ly the 2A, slightly improves the OAR dose sparing, such as lungs and heart, and reduces NTCP and MU with a better PTV coverage. 展开更多
关键词 Esophageal cancer treatment planning Intensity modulated radiotherapy Volumetric modulat-ed arc radiotherapy Normal tissue complication prob-ability
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Comparison of Dosiology between Three Dimensional Conformal and Intensity-modulated Radiotherapies (5 and 7 fields) in Gastric Cancer Post-surgery 被引量:1
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作者 马虹 韩军 +1 位作者 张涛 柯杨 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2013年第5期759-764,共6页
The purpose of this study was to compare the dose distribution of intensity-modulated ra- diotherapy (IMRT) in 7 and 5 fields as well as 3-D conformal radiotherapy (3D-CRT) plans for gastric cancer using dosimetri... The purpose of this study was to compare the dose distribution of intensity-modulated ra- diotherapy (IMRT) in 7 and 5 fields as well as 3-D conformal radiotherapy (3D-CRT) plans for gastric cancer using dosimetric analysis. In 15 patients with gastric cancer after D1 resection, dosimetric pa- rameters for IMRT (7 and 5 fields) and 3D-CRT were calculated with a total dose of 45 Gy (1.8 Gy/day) These parameters included the conformal index (CI), homogeneity index (HI), maximum dose spot for the planned target volume (PTV), dose-volume histogram (DVH) and dose distribution in the organs at risk (OAR), mean dose (Dmean), maximal dose (Dmax) in the spinal cord, percentage of the normal liver volume receiving more than 30 Gy (V30) and percentage of the normal kidney volume receiving more than 20 Gy (V20). IMRT (7 and 5 fields) and 3D-CRT achieved the PTV coverage. However, IMRT presented significantly higher CI and HI values and lower maximum dose spot distribution than 3D-CRT (P=0.001). For dose distribution of OAR, IMRT had a significantly lower Dmean and Dmax in spinal cord than 3D-CRT (P=-0.009). There was no obvious difference in V30 of liver and V20 of kidney between IMRT and 3D-CRT, but 5-field IMRT showed lower Dmean in the normal liver than other two plans (P=0.001). IMRT revealed favorable tumor coverage as compared to 3D-CRT and IMRT plans. Specifically, 5-field IMRT plan was superior to 3D-CRT in protecting the spinal cord and liver, but this superiority was not observed in the kidney. Further studies are needed to compare differences among the three approaches. 展开更多
关键词 gastric cancer radiation therapy three-dimensional treatment planning system inten-sity-modulated radiotherapy DOSIMETRY
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Effect of Non-Delineated Normal Volumes in IMRT Treatment for Left Breast Cancer: A Treatment Planning Study
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作者 Tamer Dawod Sabbah I. Hammoury +1 位作者 Mostafa Elnaggar Mustafa Kamal 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2015年第1期13-24,共12页
Introduction: Intensity Modulated Radiation Therapy (IMRT) planning dose calculation process depends on IMRT dose constraints. So, if there was any structure along the treatment beam path not delineated, it would not ... Introduction: Intensity Modulated Radiation Therapy (IMRT) planning dose calculation process depends on IMRT dose constraints. So, if there was any structure along the treatment beam path not delineated, it would not be taken into account during that calculation process. During IMRT routine practical work, it is noticed that there are some non-delineated normal tissue volumes that received un-aimed dose. Aim: The purpose of this study was to study the effect of unusually delineated normal volumes in IMRT treatment for left sided breast cancer. Method: Ten left sided breast cancer patients were planned with IMRT inverse planning system. The unusually delineated normal volumes were delineated and taken into account in IMRT dose constraints as an Organ at Risk. Doses received by that volume were compared in the two methods quantitatively from Dose Volume Histograms (DVHs) and qualitatively from (axial cuts). Results: The results showed that doses received by the unusually delineated volume when they were delineated and taken into account in IMRT dose constraints were significantly higher than when they were not. Conclusions: The results showed that for IMRT planning technique used for treating left-sided breast cancer, all of the normal tissues/structures that are closed to the treatment targets must be delineated and taken into account in the IMRT planning dose constraints. 展开更多
关键词 radiotherapy IMRT Linear Accelerator treatment planning system TPS NTIAV
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Comparison between 4D robust optimization methods for carbon-ion treatment planning
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作者 Wen-Yu Wang Yuan-Yuan Ma +4 位作者 Hui Zhang Xin-Yang Zhang Jing-Fen Yang Xin-Guo Liu Qiang Li 《Nuclear Science and Techniques》 SCIE EI CAS CSCD 2023年第9期94-105,共12页
Intensity-modulated particle therapy(IMPT)with carbon ions is comparatively susceptible to various uncertainties caused by breathing motion,including range,setup,and target positioning uncertainties.To determine relat... Intensity-modulated particle therapy(IMPT)with carbon ions is comparatively susceptible to various uncertainties caused by breathing motion,including range,setup,and target positioning uncertainties.To determine relative biological effectiveness-weighted dose(RWD)distributions that are resilient to these uncertainties,the reference phase-based four-dimensional(4D)robust optimization(RP-4DRO)and each phase-based 4D robust optimization(EP-4DRO)method in carbon-ion IMPT treatment planning were evaluated and compared.Based on RWD distributions,4DRO methods were compared with 4D conventional optimization using planning target volume(PTV)margins(PTV-based optimization)to assess the effectiveness of the robust optimization methods.Carbon-ion IMPT treatment planning was conducted in a cohort of five lung cancer patients.The results indicated that the EP-4DRO method provided better robustness(P=0.080)and improved plan quality(P=0.225)for the clinical target volume(CTV)in the individual respiratory phase when compared with the PTV-based optimization.Compared with the PTV-based optimization,the RP-4DRO method ensured the robustness(P=0.022)of the dose distributions in the reference breathing phase,albeit with a slight sacrifice of the target coverage(P=0.450).Both 4DRO methods successfully maintained the doses delivered to the organs at risk(OARs)below tolerable levels,which were lower than the doses in the PTV-based optimization(P<0.05).Furthermore,the RP-4DRO method exhibited significantly superior performance when compared with the EP-4DRO method in enhancing overall OAR sparing in either the individual respiratory phase or reference respiratory phase(P<0.05).In general,both 4DRO methods outperformed the PTV-based optimization in terms of OAR sparing and robustness. 展开更多
关键词 Intensity-modulated particle therapy Carbon-ion radiotherapy Uncertainties Four-dimensional robust optimization Lung cancer Relative biological effectiveness-weighted dose Robustness treatment planning system
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Evolving role of salvage reirradiation: Is global harmonization required before treatment guidelines can be developed?
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作者 Natalie Logie C Suzanne Drodge +1 位作者 Oleksandr Boychak Alysa Fairchild 《World Journal of Meta-Analysis》 2015年第3期133-138,共6页
Up to 90% of patients initially treated with curativeintent radiotherapy(RT) will experience locoregional failure. Historically, reirradiation(Re RT) was offered purely with palliative intent, if considered at all, du... Up to 90% of patients initially treated with curativeintent radiotherapy(RT) will experience locoregional failure. Historically, reirradiation(Re RT) was offered purely with palliative intent, if considered at all, due to concerns surrounding toxicity, tolerance of normal tissues, and choice of appropriate dose schedule. With technological advancements in RT delivery, coupled with longer survival in many malignancies secondary to improvements in systemic therapy, a small subset of patients presenting with localized recurrence is increasingly being offered salvage Re RT. However, this is largely on an ad hoc basis, guided mainly by small retrospective, single-institution reports. The patient population retreated, RT modality, dose received, degree of attrition and follow-up are extremely variable. The opportunity presently exists to apply lessons learned from the harmonization of the research efforts within the bone metastases community to the salvage Re RT situation: the adoption of common endpoints, minimum features to be incorporated into clinical trial design, and methods of data analysis and reporting. The Re RT data available must be harmonized so that valid, clinically applicable conclusions can be drawn. Collaboration in the form of an international registry of prospectively collected outcomes of patients reirradiated for cure for a variety of tumour sites would further support the evolution of Radiation Oncology towards personalized medicine, and away from the current "one-dose-fits-all" approach. 展开更多
关键词 REIRRADIATION SALVAGE treatment planning Toxicity REGISTRY Dose radiotherapy
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Current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy
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作者 Wing-Yan Ip Fu-Ki Yeung +3 位作者 Shang-Peng Felix Yung Hong-Cheung Jeffrey Yu Tsz-Him So Varut Vardhanabhuti 《Artificial Intelligence in Medical Imaging》 2021年第2期37-55,共19页
Artificial intelligence(AI)has seen tremendous growth over the past decade and stands to disrupts the medical industry.In medicine,this has been applied in medical imaging and other digitised medical disciplines,but i... Artificial intelligence(AI)has seen tremendous growth over the past decade and stands to disrupts the medical industry.In medicine,this has been applied in medical imaging and other digitised medical disciplines,but in more traditional fields like medical physics,the adoption of AI is still at an early stage.Though AI is anticipated to be better than human in certain tasks,with the rapid growth of AI,there is increasing concerns for its usage.The focus of this paper is on the current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy.Topics on AI for image acquisition,image segmentation,treatment delivery,quality assurance and outcome prediction will be explored as well as the interaction between human and AI.This will give insights into how we should approach and use the technology for enhancing the quality of clinical practice. 展开更多
关键词 Artificial intelligence Medical physics radiotherapy Image acquisition Image segmentation treatment planning treatment delivery Quality assurance
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Effect of Breathing on Exposed Lung Volumes and Doses in Patients with Breast Carcinoma Receiving Radiotherapy
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作者 Evren Ozan Goksel Evrim Tezcanli +5 位作者 Melahat Garipagaoglu Oznur Senkesen Halil Kücücük Meric Sengoz Nuran Bese Isik Aslay 《International Journal of Medical Physics, Clinical Engineering and Radiation Oncology》 2013年第3期92-97,共6页
Introduction: This study evaluates the changes in the lung volume (LV) exposed radiation during the breath cycle and whether these volume differences have an effect on both lung and target doses in breast carcinoma pa... Introduction: This study evaluates the changes in the lung volume (LV) exposed radiation during the breath cycle and whether these volume differences have an effect on both lung and target doses in breast carcinoma patients. Material and Methods: Ten patients with left breast carcinoma underwent breast conservative surgery or mastectomy receiving radiotherapy (RT) (breast or chest wall and regional lymph nodes) were included. For this study, planning computerized tomography (CT) images were obtained during deep inspiration (DI) and end of expiration (EE), besides free breathing (FB) to simulate breath cycles. Three-dimensional conformal or intensity-modulated RT planning was done to obtain dose-volume information using CT series taken FB, DI and EE. The treatment plan was done with FB images and exported to the DI and EE scans and re-calculated. Volume changes and calculated dose differences according to breath cycles were compared. Results: There were significant differences in the whole LV, ipsilateral LV and contralateral LV between FB-DI and EE-DI while no significant difference was seen between FB and EE. V20 was lower during DI than FB and EE but the difference was not significant. There was no significant variation in whole breast dose although significant dose variations were observed in mean MI, supraclaviculary and level III axillary lymph node doses between breath cycles. Conclusion: Breath cycle had no significant effect on whole breast dose although significantly changed regional lymph node doses in patients with breast carcinoma receiving whole breast and regional lymph nodes radio-therapy. V20 dose was lower during DI than FB and EE, but the difference was not significant. 展开更多
关键词 radiotherapy treatment planning Breast Carcinoma Lung Volume Lung Dose Breath Cycle
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非共面照射野在舌癌放疗中对脊髓和下颌骨重点保护的效果评价
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作者 石慧烽 涂文勇 +3 位作者 胡海生 樊文慧 毕帆 劳峥 《中国口腔颌面外科杂志》 CAS 2024年第1期58-62,共5页
目的 :在舌癌术后放疗计划中重点保护脊髓和下颌骨的前提下,通过比较共面野与非共面野计划两者放疗剂量分布的差异,探讨非共面照射野在放疗计划中对脊髓和下颌骨的重点保护效果,从而选择合理放疗方案,以应对舌癌复发需再次放疗的可能性... 目的 :在舌癌术后放疗计划中重点保护脊髓和下颌骨的前提下,通过比较共面野与非共面野计划两者放疗剂量分布的差异,探讨非共面照射野在放疗计划中对脊髓和下颌骨的重点保护效果,从而选择合理放疗方案,以应对舌癌复发需再次放疗的可能性。方法:选择上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科在2018年2月—2023年2月收治的15例舌癌术后放疗患者作为研究对象,采用实际治疗的靶区作为计算目标,正常组织剂量限值参照国家标准,在其他参数保持不变的前提下,仅仅变动脊髓以及下颌骨的限量函数。函数采用serial函数,限量由低到高分为20、25、30、35、40,在Monaco计划系统中自动计算,对计划各个参数进行评价(靶区CI、HI、D98、D95、D5、D2),正常组织脊髓的最大量,腮腺、喉、下颌骨的平均量。采用SPSS 20.0软件包对数据进行统计学分析。结果:非共面野的各项评价指标优于共面野计划。共面野计划在serial函数限值为20、25时,靶区评价指标D98、D95、D5、D2形成剂量趋势曲线存在发散状态,靶区归一性较差。随着限值提高,2组计划的靶区剂量趋势曲线相差变小,靶区归一性基本统一。统计结果显示,相对于非共面野计划,共面野计划在seiral函数为20、25时,脊髓、左右侧腮腺、喉、下颌骨以及靶区的CI、HI的结果较差,2组差异有统计学意义(P<0.05);特别在serial函数为20时差异值最大,HI指数差异为7.7%,CI差异为14%。随着限值提高,2组数据差异逐渐变小,多数评价指标差值有统计学意义(P<0.05)。结论:舌癌术后放疗计划中,在脊髓、下颌骨限量较为严格时,2组计划剂量差异较大,计划射野时建议选择非共面角度。随着限量提高,差异性逐渐变小。虽然多数指标仍存在统计学差异,但鉴于非共面野有转床的误差存在,计划射野时,可根据患者情况以及机器精度进行合理选择。 展开更多
关键词 非共面照射 Monaco治疗计划系统 舌癌 放疗
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三维适形放疗联合^(89)SrCl_(2)治疗前列腺癌骨转移的效果研究
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作者 陶绪长 刘瑞祺 +2 位作者 陈慧娟 邓益杰 李凤瑛 《实用癌症杂志》 2024年第12期2021-2025,共5页
目的探讨三维适形放疗联合^(89)SrCl_(2)对前列腺癌骨转移患者的治疗效果。方法选择前列腺癌骨转移患者(骨转移部位为脊柱/骨盆)60例为对象,信封法分为两组,各30例。对照组采用三维适形放疗,观察组联合^(89)SrCl_(2)治疗,两组均完成3个... 目的探讨三维适形放疗联合^(89)SrCl_(2)对前列腺癌骨转移患者的治疗效果。方法选择前列腺癌骨转移患者(骨转移部位为脊柱/骨盆)60例为对象,信封法分为两组,各30例。对照组采用三维适形放疗,观察组联合^(89)SrCl_(2)治疗,两组均完成3个月治疗,比较两组有效率、视觉模拟疼痛(VAS)、Karnofsky活动状态评分(KPS评分)、白细胞计数、血小板计数、血红蛋白水平、前列腺特异性抗原(PAS)、癌胚抗原(CEA)、I型胶原羧基端肽β特殊序列(β-CTx)、骨转化生化标志物I型前胶原氨基端延长肽(TPINP)、血清睾酮水平及不良反应发生率。结果观察组治疗3个月有效率高于对照组(P<0.05);观察组干预后VAS评分低于对照组(P<0.05);KPS得分高于对照组(P<0.05);观察组干预后WBC、PLT及Hb高于对照组(P<0.05);观察组干预后PAS、CEA、β-CTx、TPINP及血清睾酮水平低于对照组(P<0.05);两组不良反应比较无统计差异(P>0.05)。结论三维适形放疗联合^(89)SrCl_(2)能提高前列腺骨癌转移患者治疗有效率,可减轻前列腺癌骨转移患者疼痛,提高患者生活质量,白细胞、血小板及血红蛋白抑制程度较轻,有助于降低肿瘤标志物水平,且未增加不良反应发生率,值得推广应用。 展开更多
关键词 三维适形放疗 ^(89)SrCl_(2)治疗 前列腺癌骨转移 治疗效果 肿瘤标志物 不良反应
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直肠癌和宫颈癌容积调强计划的ArcCheck三维剂量验证应用分析
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作者 郑超 钟青松 《中国医疗设备》 2024年第11期51-55,68,共6页
目的探究ArcCheck-3DVH在直肠癌与宫颈癌调强放疗计划上的三维剂量验证效果,并探讨该设备在2组计划剂量验证结果上的差异。方法选取基于Monaco 6.1计划系统的19例直肠癌与21例宫颈癌计划为研究对象。采用SNC Patient计算并比较diff/Dist... 目的探究ArcCheck-3DVH在直肠癌与宫颈癌调强放疗计划上的三维剂量验证效果,并探讨该设备在2组计划剂量验证结果上的差异。方法选取基于Monaco 6.1计划系统的19例直肠癌与21例宫颈癌计划为研究对象。采用SNC Patient计算并比较diff/Dist=3 mm/3%、阈值TH=10条件下放疗计划系统(Treatment Planning System,TPS)与ArcCheck模体测得的γ通过率。再采用3DVH系统重建靶区与危及器官的三维剂量分布,比较其与TPS在D98%(98%的靶区体积接受的最小剂量)、D_(2%)(2%的靶区体积接受的最小剂量)和D_(mean)(平均剂量)等参数条件下的剂量差异。结果19例直肠癌计划在SNC Patient上计算得到的平均γ通过率为99.46%±0.70%,大于3DVH的98.88%±0.46%,且剂量差异具有统计学意义(P<0.05)。临床靶区的γ通过率均大于94%且在D_(2%)下剂量差异存在统计学意义(P<0.05)。危及器官的γ通过率均大于95%且除小肠V40(器官接受至少40 Gy剂量的体积百分比)、脊髓D_(mean)外,其余危及器官在各参数下差异均无统计学意义(P>0.05)。21例宫颈癌计划在SNC Patient上计算得到的γ通过率为99.67%[99.35%,99.95%],大于3DVH的98.49%[98.05%,98.95%],且两者之间的差异具有统计学意义(P<0.05)。临床靶区的γ通过率均大于93.70%并在D_(mean)和D_(2%)下的剂量差异具有统计学意义(P<0.05)。危及器官的γ通过率均大于91%,且除直肠V30(器官接受至少30 Gy剂量的体积百分比)、脊髓D_(mean)外,其余器官在各参数下的剂量差异均具有统计学意义(P<0.05)。结论ArcCheck-3DVH系统不仅能整体评估直肠癌和宫颈癌容积旋转调强放疗计划的剂量验证结果,还能进一步提供靶区与危及器官的测量重建剂量和与TPS计算剂量之间的差异。 展开更多
关键词 ArcCheck-3DVH 三维剂量验证 调强放疗 容积旋转调强放疗(VMAT) 宫颈癌 直肠癌 放疗计划系统(TPS)
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糖尿病足溃疡合并感染治疗及护理1例
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作者 黄育姑 张菊云 +1 位作者 蒙绪标 黄婵娟 《医学新知》 CAS 2024年第8期943-949,共7页
糖尿病足溃疡(diabetic foot ulcers,DFU)是糖尿病的严重并发症,是非创伤截趾或截肢的首要原因。然而,DFU治愈率较低,DFU患者生活及生存质量仍受到严重威胁。本研究报道中南大学湘雅医学院附属海口医院1例DFU合并感染患者治疗及护理过程... 糖尿病足溃疡(diabetic foot ulcers,DFU)是糖尿病的严重并发症,是非创伤截趾或截肢的首要原因。然而,DFU治愈率较低,DFU患者生活及生存质量仍受到严重威胁。本研究报道中南大学湘雅医学院附属海口医院1例DFU合并感染患者治疗及护理过程,以期为DFU的临床治疗和护理提供参考。 展开更多
关键词 糖尿病足溃疡 治疗方案 多维度综合护理 病例报告
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调强技术、治疗部位以及剂量体积算法对调强放疗计划三维剂量验证结果的影响研究
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作者 彭先成 刘晏明 +3 位作者 鲁文力 张瀚尹 李英 易鑫 《医疗卫生装备》 CAS 2024年第11期54-59,共6页
目的:研究调强技术、治疗部位以及剂量体积算法对调强放疗(intensity-modulated radiation therapy,IMRT)计划三维剂量验证结果的影响,探究建立个体化放疗计划质量保证(quality assurance,QA)评估标准的重要性。方法:回顾性选取2017年1... 目的:研究调强技术、治疗部位以及剂量体积算法对调强放疗(intensity-modulated radiation therapy,IMRT)计划三维剂量验证结果的影响,探究建立个体化放疗计划质量保证(quality assurance,QA)评估标准的重要性。方法:回顾性选取2017年1月—2022年2月在某院接受放疗的350例肿瘤患者IMRT计划的三维剂量验证结果,通过COMPASS系统进行数据采集,分别以不同调强技术(固定射束调强放疗、容积旋转调强放疗)、治疗部位(颈部、胸部和腹部)和剂量体积算法(各向异性解析算法和坍缩锥卷积算法)进行分组。比较各组3%/2 mm标准下的10%处方剂量区域的Gamma通过率(GP_(10%))、50%处方剂量区域的Gamma通过率(GP_(50%))和50%处方剂量区域的平均Gamma指数(μGI_(50%)),95%靶区体积的剂量D_(95%)、5%靶区体积的剂量D_(5%)和靶区平均剂量Dmean,头颈部放疗计划下腮腺的平均剂量D_(mean)、1%脊髓体积的剂量D_(1%)和1%脑干体积的剂量D_(1%),胸部放疗计划下肺、心脏的平均剂量D_(mean)和1%脊髓体积的剂量D_(1%),腹部放疗计划下膀胱、直肠和股骨头的平均剂量D_(mean)。采用SPSS 26.0软件进行统计学分析。结果:对于不同调强技术,除了腹部放疗计划的GP_(50%)之外,其余QA结果差异有统计学意义(P<0.05)。对于不同治疗部位,头颈部和腹部放疗计划、胸部和腹部放疗计划的QA结果差异有统计学意义(P<0.05),头颈部和胸部放疗计划的QA结果差异无统计学意义(P>0.05)。对于不同剂量体积算法,除了腹部放疗计划计划靶区(planning target volume,PTV)的D5%和胸部放疗计划PTV的D_(mean)和脊髓的D1%之外,其余的QA结果差异有统计学意义(P<0.05)。结论:剂量验证结果会因调强技术、治疗部位和剂量体积算法的不同而产生差异。当通用评估阈值不适用时,可考虑采用AAPM TG-218号报告所推荐的统计过程控制方法建立符合实际情况的放疗计划个性化QA评估标准。 展开更多
关键词 调强技术 治疗部位 剂量体积算法 调强放疗计划 三维剂量验证
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4DCT联合呼吸管理对NSCLC SBRT治疗精度的影响
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作者 祖国红 孙美丽 +3 位作者 窦岩 岳晨曦 汪延明 赵惠 《中国卫生标准管理》 2024年第19期88-92,共5页
目的通过对比四维X线断层扫描(four dimension computed tomography,4DCT)联合呼吸门控、腹部加压以及自由呼吸模式下立体定向放射治疗(stereotactic body radiotherapy,SBRT)计划参数的对比,分析呼吸管理对肿瘤靶区体积、剂量精度的影... 目的通过对比四维X线断层扫描(four dimension computed tomography,4DCT)联合呼吸门控、腹部加压以及自由呼吸模式下立体定向放射治疗(stereotactic body radiotherapy,SBRT)计划参数的对比,分析呼吸管理对肿瘤靶区体积、剂量精度的影响。方法选取2021年10月—2022年12月在山东第一医科大学附属中心医院肿瘤科就诊的12例早期非小细胞肺癌(non-small cell lung cancer,NSCLC)采用立体定向放射治疗的患者,分别设计3套图像计划,每套图像12例为一组。搜集4DCT扫描图像,按呼吸时相将CT数据重建,分层处理得到0%~90%图像(0%为吸气末,50%为呼气末),勾画各时相肿瘤靶区,利用最大密度投影融合成全时相图像,用来模拟自由呼吸模式下的普通CT图像(FB'组);将30%~70%时相图像用最大密度投影融合,因其与利用呼吸附件腹部加压后其呼吸时相相同,定义为腹部适度加压组图像(RA'组);将吸气末0%时相图像模拟主动呼吸控制状态图像(ABC'组)。在这3组图像上分别得到肿瘤靶区、肿瘤内靶区及计划靶区,比较3组治疗模式中肿瘤靶区及危机器官剂量学差异。结果(1)ABC'组、RA'组及FB'组肿瘤内靶区体积值差异有统计学意义(P<0.05)。计划靶区适形性指数、均匀性指数、5%计划靶区(planned target volume,PTV)体积的剂量及体积的剂量、及95%PTV体积的剂量差异均无统计学意义(P>0.05)。(2)ABC'组、RA'组及FB'组患者计划靶区双肺剂量5 Gy照射时的百分体积、双肺剂量20 Gy照射时的百分体积、平均肺剂量,差异有统计学意义(P<0.05)。心脏最大剂量、<15 cm^(3)体积的剂量示RA'组、ABC'组均略低于FB'组,但差异无统计学意义(P>0.05)。结论在非小细胞肺癌立体定向放射治疗中应用呼吸门控、适度腹部加压等呼吸管理方式联合4DCT,较自由呼吸模式下的FB'组有效地减小肿瘤内靶区体积、双肺剂量5 Gy的百分体积、双肺剂量20 Gy的百分体积、平均肺剂量等指标,减少呼吸动度对靶区的影响,提高定位、治疗的精度。腹部加压呼吸管理技术是对呼吸门控呼吸管理技术不适应者的一种有效补救措施。 展开更多
关键词 四维X线断层扫描 联合呼吸管理 非小细胞肺癌 立体定向放射治疗 治疗计划 精度影响
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计算机模拟放疗计划临床应用中的若干技巧
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作者 罗宏瀚 《计算机应用文摘》 2024年第20期156-158,共3页
针对放疗计划计算模拟过程中出现的若干常见问题,文章依据主流计划系统的原理分析并提出了解决方法,分别列举了食道癌和带淋巴结靶区的宫颈癌实例,通过对比说明了所提方法的应用效果。
关键词 计算机模拟 放疗计划 治疗
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乳腺癌调强放射治疗和常规切线野治疗的三维剂量学研究 被引量:62
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作者 黄晓波 蒋国樑 +2 位作者 陈佳艺 陈兰飞 胡伟刚 《癌症》 SCIE CAS CSCD 北大核心 2006年第7期855-860,共6页
背景与目的:乳房保留治疗已在早期乳腺癌患者中逐渐推广应用,其中全乳根治性放疗的标准技术通常采用常规切线野技术。调强放射治疗(intensity-modulatedradiotherapy,IMRT)技术有望在保障相同疗效的同时进一步减少放疗并发症,提高生活... 背景与目的:乳房保留治疗已在早期乳腺癌患者中逐渐推广应用,其中全乳根治性放疗的标准技术通常采用常规切线野技术。调强放射治疗(intensity-modulatedradiotherapy,IMRT)技术有望在保障相同疗效的同时进一步减少放疗并发症,提高生活质量。本研究利用三维计划系统评价全乳IMRT的剂量学优势与适应证。方法:选择10例接受保乳手术的Tis~2N0M0早期乳腺癌病例,利用三维治疗计划系统为每例患者设计两种全乳放射治疗计划,切线野常规计划与IMRT计划,处方剂量均为5000cGy。用剂量体积直方图(dosevolumehistograms,DVH)来比较各种计划中计划靶体积(planningtargetvolume,PTV)、危及器官(organsatrisks,OARs)的剂量学差异。结果:靶区覆盖率在两种计划中相似,分别为98.3%和97.7%。与常规计划比较,IMRT计划的PTV接受<95%处方剂量与>103%处方剂量的体积百分比之和(inhomogeneityindex,IHI)从29.9%减少到2.9%,PTV接受至少105%处方剂量照射的体积百分比(V105%)从28.2%减少到0.6%;IMRT计划改善IHI和减少V105%的平均值在PTV较大的患者中优势更明显。左侧患者中冠状动脉的最大剂量(Dmax)以及心脏的平均剂量(Dmean)分别从5057.1cGy减少到4832.9cGy和从629.8cGy到450.7cGy;右侧患者肝脏的Dmean从283.9cGy减少到172.0cGy;所有患者中同侧肺的Dmean、至少接受20Gy照射的体积百分比(V20)分别从925.2cGy减少到765.9cGy,从16.0%到15.3%,Dmean与V20的平均值在IMRT计划中减少的百分比在不同射野中心肺厚度(centrallungdistance,CLD)亚组中分别是14.7%与20.9%,7.0%与12.9%;对侧乳腺和对侧肺的Dmean也分别从75.4cGy减少到20.3cGy和从30.9cGy到16.1cGy。结论:全乳IMRT的剂量学优势主要在于保证靶区覆盖率的前提下,显著改善靶区的剂量分布均匀性并一定程度上降低OARs的受照剂量与容积。乳房体积和CLD较大的病例可以通过IMRT技术获得更好的剂量学结果。 展开更多
关键词 乳腺肿瘤/放射疗法 调强放射治疗 三维治疗计划系统 剂量体积直方图 乳房保留治疗
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应用4D-CT技术确定肝癌内靶体积及相关剂量学研究 被引量:13
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作者 习勉 刘孟忠 +7 位作者 邓小武 刘慧 黄晓延 张黎 李巧巧 胡永红 蔡玲 崔念基 《癌症》 SCIE CAS CSCD 北大核心 2007年第1期1-8,共8页
背景与目的:由于肝脏肿瘤的位移受呼吸运动的影响显著,三维适形放射治疗(three-dimensionalconformalradiotherapy,3DCRT)难以准确定位靶区。本研究应用4D-CT技术确定个体化肝癌内靶体积(internaltargetvolume,ITV),比较3D计划与4D计划... 背景与目的:由于肝脏肿瘤的位移受呼吸运动的影响显著,三维适形放射治疗(three-dimensionalconformalradiotherapy,3DCRT)难以准确定位靶区。本研究应用4D-CT技术确定个体化肝癌内靶体积(internaltargetvolume,ITV),比较3D计划与4D计划的计划靶体积(planningtargetvolume,PTV)及相关剂量学差异,并评价4D-CT的优势。方法:选择7例原发性肝癌患者,行4D-CT门控扫描,在10个相位的CT图像中分别勾画大体肿瘤体积(grosstumorvolume,GTV)和临床靶体积(clinicaltargetvolume,CTV)。在20%呼吸时相CT图像中利用三维治疗计划系统根据PTV-3D、PTV-4D为每例患者设计两套放疗计划:3D计划与4D计划。PTV-3D由CTV外扩常规的安全边界得到;PTV-4D由10个时相的CTV融合形成的ITV-4D外扩摆位边界(SM)得到。两套计划的处方剂量、射野方式均相同。比较两套计划中靶区体积、靶区与危及器官的剂量学、正常组织并发症概率的差异。结果:PTV-3D、PTV-4D的体积分别为(417.60±197.70)cm3、(331.90±183.10)cm3,后者体积减少20.50%(12.60%~34.40%);两者靶区覆盖率与剂量分布均匀性无显著性差异;4D计划中危及器官(肝、肾、胃、小肠)的受照剂量均较3D计划降低,以肝最为显著。肝V30、V40分别由38.77%、27.32%降至33.59%、22.62%;正常肝平均剂量由24.13Gy下降为21.50Gy;肝并发症概率由21.57%下降为15.86%;在不增加正常组织并发症的前提下,4D计划的处方剂量可由(50.57±1.51)Gy提升至(54.86±2.79)Gy,平均提高9.72%(4.00%~16.00%)。结论:3D计划存在遗漏靶区或过度扩大靶区的缺陷。应用4D-CT技术可在3DCRT的基础上准确定位肝癌靶区,进一步减少正常组织的受照剂量,并提升靶区剂量。 展开更多
关键词 肝肿瘤/放射疗法 三维治疗计划系统 4D—CT 剂量学
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三维适形放射治疗鼻咽癌的疗效及局部复发的因素分析 被引量:20
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作者 汤轶强 罗伟 +2 位作者 何智纯 孙颖 卢泰祥 《癌症》 SCIE CAS CSCD 北大核心 2006年第3期330-334,共5页
背景与目的:鼻咽癌常规二维放射治疗的效果不尽人意,三维适形放射治疗可以得到比二维放射治疗更优的剂量分布。本研究探讨鼻咽癌三维适形放射治疗的效果和意义,并探索影响局部复发的剂量学因素。方法:回顾性分析87例进行三维适形放射治... 背景与目的:鼻咽癌常规二维放射治疗的效果不尽人意,三维适形放射治疗可以得到比二维放射治疗更优的剂量分布。本研究探讨鼻咽癌三维适形放射治疗的效果和意义,并探索影响局部复发的剂量学因素。方法:回顾性分析87例进行三维适形放射治疗的初治鼻咽癌患者,并对7例局部区域复发病例进行剂量学分析。结果:全组共有5例原发灶和2例颈部淋巴结复发,3年局部区域控制率为90.2%,T1、T2、T3和T4的局部控制率分别为95.0%、97.0%、80.1%和100%(P=0.340)。剂量学分析显示大多数患者(5/7)为野外或野边缘复发。无进展生存超过12个月的62例患者3~4级晚期反应的发生率为9.7%。87例患者的3年总生存率和3年无进展生存率分别为88.2%和80.3%,Q92分期Ⅰ期、Ⅱ期、Ⅲ期和Ⅳa期的3年生存率分别为100%、100%、84.7%和47.5%(P<0.001)。结论:初治鼻咽癌的三维适形放射治疗可以取得较好的疗效。靶区勾画范围不足,是导致局部复发的原因之一。 展开更多
关键词 鼻咽肿瘤 三维适形放射治疗 疗效 局部复发 剂量学分析
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