丁寿亮,刘红冬,王彬,李永宝,刘镖水,夏云飞,黄晓延,吴德华.基于磁共振加速器系统头颈部肿瘤自适应放射治疗的剂量学评估[J].中华放射医学与防护杂志,2021,41(7):499-503
基于磁共振加速器系统头颈部肿瘤自适应放射治疗的剂量学评估
Dose evaluation of adaptive radiotherapy using high-field MR-Linac systems for head and neck cancers
投稿时间:2020-11-05  
DOI:10.3760/cma.j.issn.0254-5098.2021.07.004
中文关键词:  磁共振加速器  自适应放射治疗  剂量评估
英文关键词:MR-Linac  Adaptive plan  Dose evaluation
基金项目:国家自然科学基金项目(11805292);广东省自然科学基金项目(2018A0303100020)
作者单位E-mail
丁寿亮 南方医科大学南方医院放疗科, 广州 510515  
刘红冬 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
王彬 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
李永宝 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
刘镖水 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
夏云飞 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
黄晓延 中山大学肿瘤防治中心放疗科, 华南肿瘤学国家重点实验室肿瘤医学协同创新中心, 广州 510060  
吴德华 南方医科大学南方医院放疗科, 广州 510515 18602062748@163.com 
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中文摘要:
      目的 探讨头颈部肿瘤患者基于磁共振加速器系统开展自适应放射治疗的可行性。方法 回顾性分析2019年在中山大学肿瘤防治中心采用磁共振加速器上开展自适应放射治疗的6例头颈部肿瘤患者,共计128个治疗分次的在线自适应治疗计划。评估分次间靶区处方剂量覆盖和危及器官最大剂量或平均剂量的变化情况。然后将每个治疗分次计划剂量叠加后,比较靶区处方剂量覆盖和各危及器官剂量与参考计划的差异。结果 分次间靶区和危及器官剂量评估结果显示,靶区处方剂量覆盖变化<1%,均满足临床要求。脑干、视交叉、视神经、眼球分次间最大剂量和平均剂量变化较小,但眼晶状体剂量变化最大可达98%。累积剂量评估结果显示,靶区处方剂量覆盖和参考计划无明显差别(<1%),脑干、视交叉、视神经、眼球的剂量低于参考计划。眼晶状体剂量变化明显,其剂量高于参考计划最大为31.7%。结论 靶区与危及器官的累积受照剂量和分次间剂量均满足临床要求,磁共振加速器系统开展头颈部肿瘤自适应放射治疗方案是可行的。眼晶状体实际受照剂量与参考计划差异较大,应在临床中予以考虑。
英文摘要:
      Objective To investigate the feasibilityof the adaptive radiotherapy using high-field MR-Linac systems for head neck cancers and perform the evaluation of target coverage and dose criteria. Methods This study investigated 128 treatment plans of six patients who were treated on 1.5T MR-Linacsystems in Sun Yat-sen University Cancer Center in 2019, compared the differences in target coverage and dose criteria between the dose accumulation in the adaptive radiotherapy using MR-Linac systems and the reference plans, and evaluated the target coverage and dose criteria of each fraction of adaptive plan based on daily MRI anatomy. Results There was no significant change in the target coverage and dose criteria for each treatment fraction(<1%). However, the change of lens dose was significant (maximum 98%). In addition, the result showed that there was no significant difference in target coverage and dose criteria between the dose accumulation in adaptive radiotherapy using MR-Linac systems and reference plans.In contrast, the average dose to lens was increased by 31.7%. Conclusions It is feasible to perform adaptive radiotherapy using 1.5T MR-Linacsystems for head neck cancers according tothe evaluation of target coverage and dose criteria. Additionally, since the actual dose tolens was quite different from the reference plan, the lens exposure should be considered in clinical practice.
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