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Consensus on the integrated application of domestic radiotherapy equipment——homogenized IMRT of nasopharyngeal carcinoma:radiotherapy
Expert Group on Integrated Application of Domestic Radiotherapy Equipment; Chinese Society of Digital Medicine; Radiation Therapy Specialized Committee of Chongqing Medical Association; Radiation Therapy Specialized Committee of Chongqing Association of Integrative Medicine; Radiation Therapy Specialized Committee of Chongqing Anti-Cancer Association; West China Society of Therapeutic and Radiation Oncology
Abstract Intensity-modulated radiotherapy (IMRT) is the standard radiotherapy technique for nasopharyngeal carcinoma. In recent years,domestic radiotherapy equipment has been gradually recognized in the market,and widely applied in the hospitals at all levels. Radiotherapy technique heavily relies on the combination of modern equipment and multi-disciplinary professionals. Based on the present gaps in the performance between domestic and imported radiotherapy equipment,we drafted this consensus in accordance with the national relevant laws and regulations after referring to relevant guidelines,consensus and professional books at home and abroad,aiming to standardize the basic equipment and technical requirements for the integrated application of domestic radiotherapy equipment in the positioning and planning design of IMRT for nasopharyngeal carcinoma and define the process of diagnosis and treatment,thereby achieving the homogenization of IMRT for nasopharyngeal carcinoma between primary and Grade Ⅲ Level A hospitals and improving clinical benefits for patients.
Corresponding Authors:
Sun Jianguo,Department of Oncology,Second Affiliated Hospital of Army Military Medical University;Email:sunjg09@aliyun.com
Cite this article:
. Consensus on the integrated application of domestic radiotherapy equipment——homogenized IMRT of nasopharyngeal carcinoma:radiotherapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(4): 242-249.
. Consensus on the integrated application of domestic radiotherapy equipment——homogenized IMRT of nasopharyngeal carcinoma:radiotherapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(4): 242-249.
[1] 梁锌,杨剑,高婷,等.中国鼻咽癌流行概况[J].中国肿瘤,2016,25(11):835-840.DOI:10.11735/j.issn.1004-0242.2016.11.A001. Ling X,Yang J,Gao T,et al. Nasopharynx Cancer Epidemiology in China[J].China Cancer,2016,25(11):835-840.DOI:10.11735/j.issn.1004-0242.2016.11.A001. [2] Zhang L,Huang Y,Hong S,et al. Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma:a multicentre,randomised,open-label,phase 3 trial[J].Lancet,2016,388(10054):1883-1892.DOI:10.1016/S0140-6736(16)31388-5. [3] Huang PY,Mai HQ,Luo DH,et al. Induction-concurrent chemoradiotherapy versus induction chemotherapy and radiotherapy for locoregionally advanced nasopharyngeal carcinoma[J].Ai Zheng,2009,28(10):1033-1042. [4] 苏胜发,赵充,韩非,等.鼻咽癌适形调强放疗远期疗效分析[J].中华肿瘤防治杂志,2013,20(11):853-858.DOI:10.16073/j.cnki.cjcpt.2013.11.011. Su SF,Zhao C,Han F,et al. Long-term outcome of nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy[J].Chinese Journal of Cancer Prevention and Treatment,2013,20(11):853-858.DOI:10.16073/j.cnki.cjcpt.2013.11.011. [5] 郎锦义,王培,吴大可,等.2015年中国大陆放疗基本情况调查研究[J].中华放射肿瘤学杂志,2016,(6):541-545.DOI:10.3760/cma.j.issn.1001-4221.2016.06.001. Lang JY,Wang P,Wu DK,et al. An investigation of the basic situation of radiotherapy in mainland China in 2015[J].Chin J Radiat Oncol,2016,(6):541-545.DOI:10.3760/cma.j.issn.1001-4221.2016.06.001. [6] Ying Z,Ge W,Guanghui L,et al. Investigation on the status of radiation therapy for nasopharyngeal cancer in Chongqing city[J].Digital Medicine,2018,4(4):184.DOI:10.4103/digm.digm_32_18. [7] 王宝亭,耿鸿武,于清明,等.医疗器械蓝皮书中国医疗器械行业发展报告(2018)[M].第2版.北京:社会科学文献出版社,2018. Wang BT,Geng HW,Yu QM,et al. Blue book of medical device industry-Annual report on the development of medical device industry in china (2018)[M].2ed. Beijing:Social sciences academic press (China),2018. [8] 李晔雄,王绿化,高黎,等.肿瘤放疗学[M].第5版.北京:中国协和医科大学出版社,2018. Li YX,Wang LH,Gao L,et al. Radiation oncology[M].5ed. Beijing:Peking union medical college press,2018. [9] 孙新臣,孙向东,戴圣斌,等.肿瘤放疗临床质量保证规范[M].第1版.南京:东南大学出版社,2018. Sun XC,Sun XD,Dai SB,et al.Zhong liu fang she zhi liao lin chuang zhi liao bao zheng gui fan[M].1ed. Nanjing:Southeast University Press,2018. [10] 国家肿瘤诊疗质控中心放疗质控专家委员会,赫捷,王绿化,等.放疗质量控制基本指南[J].中华放射肿瘤学杂志,2018,41(4):335-342.DOI:10.3760/cma.j.issn.1004-4221.2018.04.001. Basic guidelines of quality control for radiotherapy[J].Chinese Journal of Radiation Oncology,2018,41(4):335-342.DOI:10.3760/cma.j.issn.1004-4221.2018.04.001. [11] 郑旭亮,邢晓汾,崔桐,等.头颈肩定位体架对放疗剂量的影响[J].中国医学物理学杂志,2017,(10):999-1003.DOI:10.3969/j.issn.1005-202X.2017.10.006. Zheng XL,Xing XF,Cui T,et al. Effect of head,neck and shoulder body-frame on radiotherapy dosage[J].Chinese Journal of Medical Physics,2017,(10):999-1003.DOI:10.3969/j.issn.1005-202X.2017.10.006. [12] 伍建华,卢泰祥,张华满,等.鼻咽癌的模拟定位技术操作程序[J].中国肿瘤,2004,(9):553-555.DOI:10.3969/j.issn.1004-0242.2004.09.005. Wu JH,Lu TX,Zhang HM,et al. Procedure and Protocol for Patient Immobilization During the Simulation of Nasopharyngeal Cancer[J].BULLETIN OF CHINESE CANCER,2004,(9):553-555.DOI:10.3969/j.issn.1004-0242.2004.09.005. [13] 谢冠慧.头颈部肿瘤放疗的CT模拟定位技术[J].中国医药指南,2012,(6):92-93.DOI:10.3969/j.issn.1671-8194.2012.06.059. [14] 许森奎,姚文燕,胡江,等.鼻咽癌发泡胶个体化塑形与标准化头枕放疗体位固定精确度比较[J].中华放射肿瘤学杂志,2015,(2):196-199.DOI:10.3760/cma.j.issn.1004-4221.2015.02.022. Xu SK,Yao WY,Hu J,et al. The research of accuracy immobilized using individualized polyurethane scaling agent compared to positioning foam with standard plastics pillow in the radiotherapy of nasopharyngeal carcinoma[J].Chinese Journal of Radiation Oncology,2015,(2):196-199.DOI:10.3760/cma.j.issn.1004-4221.2015.02.022. [15] Lin CG,Xu SK,Yao WY,et al. Comparison of set up accuracy among three common immobilisation systems for intensity modulated radiotherapy of nasopharyngeal carcinoma patients[J].J Med Radiat Sci,2017,64(2):106-113.DOI:10.1002/jmrs.189. [16] 刘晓清,罗伟,林仕荣,等.鼻咽癌放疗中个体化口腔支架的位置重复性[J].癌症,2009,28(10):1103-1107. Liu XQ,Luo W,Lin SR,et al. Placement repeatability of individual oral stent used in radiotherapy of nasopharyngeal carcinoma[J].Chin J Cancer,2009,28(10):1103-1107. [17] 张淑慧,杨敬贤,崔广余,等.放疗定位膜制作及体位固定质量控制[J].中国医学物理学杂志,2015,(4):554-558.DOI:10.3969/j.issn.1005-202X.2015.04.022. Zhang SH,Yang JX,Cui GY,et al. Quality control of positioning membrane production and posture fixation in radiotherapy[J].Chinese Journal of Medical Physics,2015,(4):554-558.DOI:10.3969/j.issn.1005-202X.2015.04.022. [18] Gilbeau L,Octave-Prignot M,Loncol T,et al. Comparison of setup accuracy of three different thermoplastic masks for the treatment of brain and head and neck tumors[J].Radiother Oncol,2001,58(2):155-162. [19] 秦伟,陈飞,时飞跃,等.模拟定位技术在放疗中的应用与发展[J].中国医疗设备,2013,(12):5-6,18.DOI:10.3969/j.issn.1674-1633.2013.12.002. Qin W,Chen F,Shi FY,et al. Development and Application of Simulation and Localization Techniques in Radiotherapy[J].China Medical Devices,2013,(12):5-6,18.DOI:10.3969/j.issn.1674-1633.2013.12.002. [20] Cooper JS,Mukherji SK,Toledano AY,et al. An evaluation of the variability of tumor-shape definition derived by experienced observers from CT images of supraglottic carcinomas (ACRIN protocol 6658)[J].Int J Radiat Oncol Biol Phys,2007,67(4):972-975.DOI:10.1016/j.ijrobp.2006.10.029. [21] Chuter R,Prestwich R,Bird D,et al. The use of deformable image registration to integrate diagnostic MRI into the radiotherapy planning pathway for head and neck cancer[J].Radiother Oncol,2017,122(2):229-235.DOI:10.1016/j.radonc.2016.07.016. [22] 任雯廷,陈辛元,戴建荣.磁共振放疗模拟定位技术应用现状与问题[J].中华放射肿瘤学杂志,2015,(1):93-96.DOI:10.3760/cma.j.issn.1004-4221.2015.01.025. [23] Emami B,Sethi A,Petruzzelli GJ.Influence of MRI on target volume delineation and IMRT planning in nasopharyngeal carcinoma[J].Int J Radiat Oncol Biol Phys,2003,57(2):481-488. [24] Frank SJ,Chao KS,Schwartz DL,et al. Technology insight:PET and PET/CT in head and neck tumor staging and radiation therapy planning[J].Nat Clin Pract Oncol,2005,2(10):526-533.DOI:10.1038/ncponc0322. [25] Lin P,Min M,Lee M,et al. Prognostic utility of (18) F-FDG PET-CT performed prior to and during primary radiotherapy for nasopharyngeal carcinoma:Index node is a useful prognostic imaging biomarker site[J].Radiother Oncol,2016,120(1):87-91.DOI:10.1016/j.radonc.2016.05.021. [26] 刘科,刘国才,刘媛媛,等.18F-FDG PET-CT功能影像引导下鼻咽癌同步加速生物调强放疗疗效分析[J].中华肿瘤防治杂志,2016,(17):1174-1179.DOI:10.16073/j.cnki.cjcpt.2016.17.012. Liu K,Liu GC,Liu YY,et al. Analysis of clinical outcomes of patients with nasopharyngeal carcinoma treated with simultaneous modulated accelerated biological radiation therapy guided by 18F-FDG PET-CT[J].Chinese Journal of Cancer Prevention and Treatment,2016,(17):1174-1179.DOI:10.16073/j.cnki.cjcpt.2016.17.012. [27] 中国鼻咽癌临床分期工作委员会.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志,2011,(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001 [28] 张艳明,吕晓波.肿瘤放疗-精确靶区勾画图解[M]:科学出版社,2017. [29] Lee AW,Ng WT,Pan JJ,et al. International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma[J].Radiother Oncol,2018,126(1):25-36.DOI:10.1016/j.radonc.2017.10.032. [30] 陈海斌.人工智能在放疗中的若干应用研究[M],2018. Chen HB.Several Application Researches of Artificial Intelligence in Radiotherapy[M],2018. [31] 沈天乐,杜向慧.人工智能在恶性肿瘤放疗领域中的应用与前景[J].浙江医学,2018,(8):783-785,795.DOI:10.12056/j.issn.1006-2785.2017.40.8.2018-928. [32] 孙鸿飞,倪昕晔.医学图像配准分类及在放疗中的应用进展[J].中华放射肿瘤学杂志,2017,(12):1457-1460.DOI:10.3760/cma.j.issn.1004-4221.2017.12.022. Sun HF,Ni XY.Classification of medical image registration and its application in radiotherapy[J].Chin J Radiat Oncol,2017,(12):1457-1460.DOI:10.3760/cma.j.issn.1004-4221.2017.12.022. [33] 谭珂,郭光友,潘新华,等.基于数字化可视人数据集的医学图像配准研究[J].军医进修学院学报,2006,(1):60-61.DOI:10.3969/j.issn.1005-1139.2006.01.026. Tan K,Guo GY,Pan XH,et al. Research of medical image registration based on dataset of digitized visible human[J].ACADEMIC JOURNAL OF PLA POSTGRADUATE MEDICAL SCHOOL,2006,(1):60-61.DOI:10.3969/j.issn.1005-1139.2006.01.026. [34] Zhao C,Han F,Lu LX,et al. Intensity modulated radiotherapy for local-regional advanced nasopharyngeal carcinoma[J].Ai Zheng,2004,23(11 Suppl):1532-1537. [35] 常熙,徐志勇,周莉钧,等.鼻咽癌逆向调强计划中照射野方向和照射野数目对剂量分布的影响[J].中国癌症杂志,2007,(04):324-328.DOI:10.3969/j.issn.1007-3639.2007.04.013. Chang X,Xu ZY,Zhou LJ,et al. Influence on dose distribution by beam direction and beam number in inverse intensity-modulated for nasopharyngeal carcinoma[J].China Oncology,2007,(04):324-328.DOI:10.3969/j.issn.1007-3639.2007.04.013. [36] 唐木涛,陈超敏,孙华斌,等.调强放疗计划系统的设计与软件实现[J].中国辐射卫生,2006,(04):415-417.DOI:10.3969/j.issn.1004-714X.2006.04.013. Tang MT,Chen CM,Sun HB,et al. Design and Software Development of Treatment Planning System in Intensity Modulated Radiotherapy[J].Chinese Journal of Radiological Health,2006,(04):415-417.DOI:10.3969/j.issn.1004-714X.2006.04.013. [37] 袁智勇,高黎,徐国镇,等.初治鼻咽癌调强放疗的初步结果[J].中华放射肿瘤学杂志,2006,(04):237-243.DOI:10.3760/j.issn:1004-4221.2006.04.002. Yuan ZY,Gao L,Xu GZ,et al. Preliminary results of intensity modulated radiation therapy for untreated nasopharyngeal carcinoma[J].Chinese Journal of Radiation Oncology,2006,(04):237-243.DOI:10.3760/j.issn:1004-4221.2006.04.002. [38] 李宝生,于金明,王立英,等.调强放疗计划[J].中国肿瘤,2001,(08):27-29.DOI:10.3969/j.issn.1004-0242.2001.08.012. Li BS,Yu JM,Wang LY,et al. Plan of Intensity Modulated Radiation Therapy[J].BULLETIN OF CHINESE CANCER,2001,(08):27-29.DOI:10.3969/j.issn.1004-0242.2001.08.012. [39] Lu SH,Cheng JC,Kuo SH,et al. Volumetric modulated arc therapy for nasopharyngeal carcinoma:a dosimetric comparison with TomoTherapy and step-and-shoot IMRT[J].Radiother Oncol,2012,104(3):324-330.DOI:10.1016/j.radonc.2011.11.017. [40] 王勇,徐玲玲,陈卫军,等.鼻咽癌多处方剂量融合正向调强计划的剂量学研究[J].浙江医学,2014,(1):45-49.Wang Y,Xu LL,Chen WJ,et al. Dosimetry study of forward treatment planning with integrated multi-prescription dose for patients with nasopharyngeal carcinoma[J].Zhejiang Medical Journal,2014,(1):45-49. [41] 李奇欣,岳麒,柏朋刚,等.鼻咽癌三种调强放疗计划剂量学对比研究[J].中华放射医学与防护杂志,2014,(8):613-616.DOI:10.3760/cma.j.issn.0254-5098.2014.08.013. Li QX,Yue Q,Bai PG,et al. Dosimetric comparison of three intensity-modulate radiation therapy treatment modules for nasopharyngeal carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2014,(8):613-616.DOI:10.3760/cma.j.issn.0254-5098.2014.08.013. [42] Cheng JC,Chao KS,Low D.Comparison of intensity modulated radiation therapy (IMRT) treatment techniques for nasopharyngeal carcinoma[J].Int J Cancer,2001,96(2):126-131.DOI:10.1002/ijc.1004. [43] Duan J,Meng X,Liu T,et al. Capability of leaf interdigitation with different inverse planning strategies in Monaco:an investigation of representative tumour sites[J].Radiat Oncol,2016,11:82.DOI:10.1186/s13014-016-0655-1. [44] Luo Y,Qin Y,Lang J.Effect of adaptive replanning in patients with locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy:a propensity score matched analysis[J].Clin Transl Oncol,2017,19(4):470-476.DOI:10.1007/s12094-016-1551-8. [45] 邵琰,王昊,陈华,等.适形指数和均匀性指数的临床应用[J].中华放射医学与防护杂志,2017,(9):717-721.DOI:10.3760/cma.j.issn.0254-5098.2017.09.016. Shao Y,Wang H,Chen H,et al. Clinical applications of conformity index and homogeneity index[J].Chin J Radiol Med Prot,2017,(9):717-721.DOI:10.3760/cma.j.issn.0254-5098.2017.09.016. [46] Kan MW,Leung LH,Yu PK.The use of biologically related model (Eclipse) for the intensity-modulated radiation therapy planning of nasopharyngeal carcinomas[J].PLoS One,2014,9(11):e112229.DOI:10.1371/journal.pone.0112229. [47] 杨海燕,王军良,周振山,等.AAA算法和PBC算法在鼻咽癌调强放疗中剂量分布的比较[J].中国医学物理学杂志,2013,30(04):4245-4247+4277.DOI:10.3969/j.issn.1005-202X.2013.04.008. Yang HY,Wang JL,Zhou ZS,et al. Comparison of Dose Distribution of Anisotropic Analytical Algorithm (AAA) and Pencil Beam Convolution (PBC) Algorithm for Intensity Modulated Radiotherapy (IMRT) Treatment of Nasopharyngeal[J].Chinese Journal of Medical Physics,2013,30(04):4245-4247+4277.DOI:10.3969/j.issn.1005-202X.2013.04.008. [48] Kry SF,Alvarez P,Molineu A,et al. Algorithms used in heterogeneous dose calculations show systematic differences as measured with the Radiological Physics Center′s anthropomorphic thorax phantom used for RTOG credentialing[J].Int J Radiat Oncol Biol Phys,2013,85(1):e95-100.DOI:10.1016/j.ijrobp.2012.08.039. [49] Zhao Y,Qi G,Yin G,et al. A clinical study of lung cancer dose calculation accuracy with Monte Carlo simulation[J].Radiat Oncol,2014,9:287.DOI:10.1186/s13014-014-0287-2. [50] Kan MW,Leung LH,Yu PK.Dosimetric impact of using the Acuros XB algorithm for intensity modulated radiation therapy and RapidArc planning in nasopharyngeal carcinomas[J].Int J Radiat Oncol Biol Phys,2013,85(1):e73-80.DOI:10.1016/j.ijrobp.2012.08.031.
[1]
Expert Group on Integrated Application of Domestic Radiotherapy Equipment;Chinese Society of Digital Medicine;Radiation Therapy Specialized Committee of Chongqing Medical Association;Radiation Therapy Specialized Committee of Chongqing Association of Integrative Medicine;Radiation Therapy Specialized Committee of Chongqing Anti-Cancer Association;West China Society of Therapeutic and Radiation Oncology. Consensus on integrated application of domestic radiotherapy equipment——homogenized IMRT of nasopharyngeal carcinoma:equipment[J]. Chinese Journal of Radiation Oncology, 2019, 28(8): 561-565.