ArcCHECK系统在食管癌螺旋断层放疗计划验证中的应用

doi:10.3760/cma.j.cn113030-20181221-00005

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摘要目的探讨ArcCHECK系统在食管癌断层治疗旋转照射和固定野照射计划验证中的应用,总结相关经验。方法对32例不同部位食管癌分别制作Helical旋转照射和Direct固定野照射验证计划,并通过ArcCHECK测量、分析,对比验证结果通过率。分析靶体积与计划验证通过率的相关性。将靶体积较小的治疗验证计划分别放在ArcCHECK模体中心和外周探测点处,分析验证通过率差异。结果 Helical计划验证通过率高于Direct计划(P<0.01),其靶体积与验证通过率的相关系数分别为-0.364和-0.042,P值分别为0.041和0.819。Helical计划采用3%/2mm标准时,高剂量区放在模体中心和外周探测点处测得的通过率不同(P=0.005),后者通过率更高;采用3%/3mm标准时与Direct计划的3%/3m、3%/2mm标准的相近(P均>0.05)。结论 Helical计划验证通过率普遍高于Direct计划,原因可能与ArcCHECK探测器的角度响应以及因更多参考点受到低剂量辐射而未参与计算有关,另外还可能跟Direct计划对断层治疗剂量控制系统要求更高有关。在Helical验证计划中,当采用3%/3mm标准时,靶体积越大,验证时出现较低通过率的可能性增加,但相关系数较低。验证计划的高剂量区位于模体中心或者探测点处都可以实现计划验证,综合考量建议放在模体等中心处。

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	王振立
	郑安平
	朱健
	杜红玲
	孙晓东
	王栋
	王慧涛
	张耀文
	朱青山
	崔振华

关键词 ：食管肿瘤/螺旋断层疗法, ArcCHECK系统, 计划验证, 质量保证

Abstract：Objective To explore the application of ArcCheck system in the validation of Helical and Direct tomotherapy plans for esophageal cancer and summarize relevant experience. Methods The Helical and Direct tomotherapy verification plans were established for 32 patients with esophageal cancer at different positions according to the doctor′s instructions, which were verified by the ArcCHECK system to compare the passing rate of the results.The correlation between the volume of the target area and the passing rate of the planned verification was analyzed. The therapeutic verification plan with a small target volume was made. The target area was placed at the center of ArcCHECK phantom and the area of detectors to statistically compare the verification passing rates. Results Helical plan showed a significantly higher passing rate than the Direct plan (P<0.01). The correlation coefficients between the target volume and the passing rate of the Helical and Direct plans were -0.364 and -0.042, and the P values were 0.041 and 0.819, respectively. For the Helical plan, when the 3%/2mm criterion was adopted, there was significant difference between placing the high-dose area at the center of the phantom and the area of detectors (P=0.005), and the passing rate of the latter was higher. There was no significant difference in the other cases (all P>0.05). Conclusions The passing rate of the Helical plan is generally higher than that of the Direct plan, which may be related to the angular response of the ArcCHECK detector and the fact that more reference points are not included for calculation due to low-dose radiation. In addition, it may also be related to the higher requirements of Direct plan for tomotherapy dose control system. In the Helical verification plan, when the 3%/3mm criterion is adopted, the larger the target volume, the higher the possibility of lower passing rate, whereas the correlation coefficient between them is relatively low. The high-dose area can be verified by the plans at the center of the phantom or the detection point. With the comprehensive consideration, we suggest putting it at the center of the phantom.

Key words： Esophageal neoplasm/helical tomotherapy ArcCHECK system Plan verification Quality assurance

收稿日期: 2018-12-21

基金资助:国家自然科学基金项目(81671785、81530060);国家重点研发计划子课题(2016YFC0105106);山东省重点研发计划(2017CXZC1206);山东省自然科学基金项目(ZR2016HQ09);河南省医学科技攻关计划(2018021020);安阳市肿瘤医院中青年科研项目专项资金([2019]23)

通讯作者: 郑安平,Email:zhenganping3@126.com;朱健,Email:zhujian.cn@163.com

引用本文:

王振立,郑安平,朱健等. ArcCHECK系统在食管癌螺旋断层放疗计划验证中的应用[J]. 中华放射肿瘤学杂志, 2020, 29(4): 273-277.

Wang Zhenli,Zheng Anping,Zhu Jian et al. Application of ArcCHECK system in the verification of tomotherapy plan for esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(4): 273-277.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20181221-00005 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2020/V29/I4/273

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