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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Development of an online adaptive solution to account for inter- and intra-fractional variations.
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Development of an online adaptive solution to account for inter- and intra-fractional variations.

机译：开发一种在线自适应解决方案以解决分数间和分数内的变化。

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摘要

PURPOSE: The current IGRT repositioning cannot fully account for the organ deformation and rotation. We introduce a comprehensive solution using gated IMRT with online adaptive replanning to manage both inter- and intra-fractional variations. METHODS AND MATERIALS: The solution includes (1) generating respiration-gated IMRT plans based on 4DCT, (2) acquiring daily gated CT in treatment position prior to the treatment using a diagnostic-quality in-room CT (CTVision, Siemens) with the same gating window as that for the planning CT, (3) performing online repositioning or adaptive replanning based on the gated CT of the day, and (4) delivering the treatment with gating. The entire solution is demonstrated with RT data from 10 selected pancreatic cancer cases. The dosimetric impact of various advanced delivery technologies was investigated. RESULTS: The online adaptive replanning based on the CT of the day combining with gating significantly improves normal tissue sparing during RT for pancreatic cancer. As the complexity of the delivery technology increases from no IGRT to with IGRT, gating and online adaptive replanning, the inter- and intra-fractional variations can be accounted for with increased adequacy. CONCLUSION: The online adaptive replanning technique based on daily respiration-gated diagnostic-quality CT combined with gated delivery can effectively correct for inter- and intra-fraction variations during radiation therapy.
机译：目的：当前的IGRT重新定位不能完全说明器官的变形和旋转。我们介绍了使用门控IMRT和在线自适应重新规划来管理分数间和分数内变化的综合解决方案。方法和材料：该解决方案包括（1）基于4DCT生成呼吸门控IMRT计划，（2）使用具有诊断功能的室内质量CT（CTVision，Siemens）在治疗之前获取治疗位置的每日门控CT。与计划CT相同的门控窗口，（3）根据当天的门控CT执行在线重新定位或自适应重新计划，以及（4）通过门控进行治疗。完整的解决方案由来自10个选定的胰腺癌病例的RT数据证明。研究了各种先进交付技术的剂量学影响。结果：基于当天CT和门控的在线自适应重计划显着改善了胰腺癌RT期间的正常组织备用。随着交付技术的复杂性从无IGRT增加到采用IGRT，门控和在线自适应重新计划，分数间和分数内的变化可以通过增加的充分性来解决。结论：基于每日呼吸门控诊断质量CT结合门控分娩的在线自适应重新计划技术可以有效纠正放射治疗期间的部分间和部分内变化。

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