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首页> 美国卫生研究院文献>Journal of Applied Clinical Medical Physics >A comparison between hydrogel spacer and endorectal balloon: An analysis of intrafraction prostate motion during proton therapy
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A comparison between hydrogel spacer and endorectal balloon: An analysis of intrafraction prostate motion during proton therapy

机译：水凝胶垫片和直肠内球囊的比较：质子治疗期间前列腺内运动分析

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The purpose of this study was to evaluate intrafraction prostate motion in patients treated with proton therapy and an endorectal balloon or a hydrogel spacer using orthogonal x‐rays acquired before and after each treatment field. This study evaluated 10 patients (662 fields throughout treatment) treated daily with an endorectal balloon (ERB) and 16 patients (840 fields throughout treatment) treated with a hydrogel spacer (GEL) without an ERB. Patient shifts were recorded before and after each treatment field, correlated with a treatment time, using x‐ray imaging and implanted fiducial alignment. For each shift, recorded in X, Y, and Z, a 3D vector was calculated to determine the positional change. There was a statistically significant difference in the mean vector shift between ERB (0.06 cm) and GEL (0.09 cm), (P < 0.001). The mean includes a large number of zero shifts, but the smallest non‐zero shift recorded was 0.2 cm. The largest shifts were, on average, in the Z direction (anterior to posterior). The average Z shift was +0.02 cm for both ERB and GEL. There was no statistical difference between ERB and GEL for shifts greater than 0.3 cm (P = 0.13) or greater than 0.5 cm (P = 0.36). For treatment times between 5 and 9 min, a majority of shifts were less than 0.2 cm, 85.9% for ERB and 73.2% for GEL. There was a significant positive correlation between the vector shifts and field time for both ERB (r = 0.2, P < 0.001) and GEL (r = 0.07, P < 0.04). We have shown that prostate motion is clinically comparable between an ERB and a hydrogel spacer, and the time dependencies are similar. A large majority of shifts for both ERB and hydrogel are well within a typical robust planning margin. For GEL patients, we chose to maintain slightly larger planning margins than for style="fixed-case">ERB due to already improved rectal sparing with style="fixed-case">GEL.
机译：这项研究的目的是使用在每个治疗视野之前和之后获得的正交X射线评估接受质子治疗和直肠内球囊或水凝胶间隔物治疗的患者的分数内前列腺运动。这项研究评估了每天用直肠内球囊（ERB）治疗的10例患者（整个治疗期间662个视野）和不使用ERB的水凝胶间隔物（GEL）治疗的16例患者（整个治疗过程中840视野）。使用X射线成像和植入的基准对准，记录每个治疗领域之前和之后的患者移位，并与治疗时间相关。对于记录在X，Y和Z中的每个偏移，计算3D向量以确定位置变化。 ERB（0.06 cm）和GEL（0.09 cm）之间的平均向量偏移有统计学上的显着差异（P <0.001）。平均值包括大量零位移，但记录的最小非零位移为0.2 cm。平均而言，最大的偏移是在Z方向（从前到后）。 ERB和GEL的平均Z偏移均为+0.02 cm。对于大于0.3 cm（P = 0.13）或大于0.5 cm（P = 0.36）的偏移，ERB和GEL之间没有统计学差异。对于5到9分钟之间的治疗时间，大多数移位小于0.2厘米，ERB为85.9％，GEL为73.2％。对于ERB（r = 0.2，P <0.001）和GEL（r = 0.07，P <0.04），矢量移位和场时间之间存在显着的正相关。我们已经显示，ERB和水凝胶垫片之间的前列腺运动在临床上是可比较的，并且时间依赖性也相似。 ERB和水凝胶的大多数变化都在典型的稳健计划余量内。对于GEL患者，我们选择保持 style =“ fixed-case”> ERB 的计划利润稍大，因为 style =“ fixed-case”> GEL 。

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