高级检索
当前位置: 首页 > 详情页

Dose tracking assessment for magnetic resonance guided adaptive radiotherapy of rectal cancers

文献详情

资源类型:
WOS体系:
Pubmed体系:

收录情况: ◇ SCIE

机构: [1]Chengdu Univ Technol, Coll Nucl Technol & Automat Engn, 1 East 3 Rd ErXian bridge, Chengdu, Peoples R China [2]Univ Elect Sci & Technol China, Dept Radiat Oncol, Sichuan Canc Hosp & Inst, Radiat Oncol Key Lab Sichuan Prov,Affiliated Canc, 55,4 Sect,Chengdu Renmin South Rd, Chengdu, Peoples R China
出处:
ISSN:

关键词: Adaptive radiotherapy MR-linac Dose tracking Synthetic CT Rectal cancer Dose accumulation

摘要:
Background Magnetic resonance-guided adaptive radiotherapy (MRgART) at MR-Linac allows for plan optimisation on the MR-based synthetic CT (sCT) images, adjusting the target and organs at risk according to the patient's daily anatomy. Conversely, conventional linac image-guided radiotherapy (IGRT) involves rigid realignment of regions of interest to the daily anatomy, followed by the delivery of the reference computed tomography (CT) plan. This study aims to evaluate the effectiveness of MRgART versus IGRT for rectal cancer patients undergoing short-course radiotherapy, while also assessing the dose accumulation process to support the findings and determine its usefulness in enhancing treatment accuracy. Methods Nineteen rectal cancer patients treated with a 1.5 Tesla MR-Linac with a prescription dose of 25 Gy (5 Gy x 5) and undergoing daily adapted radiotherapy by plan optimization based on online MR-based sCT images, were included in this retrospective study. For each adapted plan (TPadap), a second plan (TPIGRT) was generated by recalculating the reference CT plan on the daily MR-based sCT images after rigid registration with the reference CT images to simulate the IGRT workflow. Dosimetry of TPadap and TP(IGRT )was compared for each fraction. Cumulative doses on the first and last fractions were evaluated for both workflows. The dosimetry per single fraction and the cumulative doses were compared using dose-volume histogram parameters. Results Ninety-five fractions delivered with MRgART were compared to corresponding simulated IGRT fractions. All MRgART fractions fulfilled the target clinical requirements. IGRT treatments did not meet the expected target coverage for 63 out of 94 fractions (67.0%), with 13 fractions showing a V95 median point percentage decrease of 2.78% (range, 1.65-4.16%), and 55 fractions exceeding the V107% threshold with a median value of 15.4 cc (range, 6.0-43.8 cc). For the bladder, the median D-15cc values were 18.18 Gy for the adaptive fractions and 19.60 Gy for the IGRT fractions. Similarly the median D-5cc values for the small bowel were 23.40 Gy and 25.69 Gy, respectively. No statistically significant differences were observed in the doses accumulated on the first or last fraction for the adaptive workflow, with results consistent with the single adaptive fractions. In contrast, accumulated doses in the IGRT workflow showed significant variations mitigating the high dose constraint, nevertheless, more than half of the patients still did not meet clinical requirements. Conclusions MRgART for short-course rectal cancer treatments ensures that the dose delivered matches each fraction of the planned dose and the results are confirmed by the dose accumulation process, which therefore seems redundant. In contrast, IGRT may lead to target dose discrepancies and non-compliance with organs at risk constraints and dose accumulation can still highlight notable dosimetric differences.

基金:
语种:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2024]版:
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 核医学 3 区 肿瘤学
JCR分区:
出版当年[2024]版:
最新[2023]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

第一作者:
第一作者机构: [1]Chengdu Univ Technol, Coll Nucl Technol & Automat Engn, 1 East 3 Rd ErXian bridge, Chengdu, Peoples R China [2]Univ Elect Sci & Technol China, Dept Radiat Oncol, Sichuan Canc Hosp & Inst, Radiat Oncol Key Lab Sichuan Prov,Affiliated Canc, 55,4 Sect,Chengdu Renmin South Rd, Chengdu, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:53699 今日访问量:0 总访问量:4607 更新日期:2025-02-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 四川省肿瘤医院 技术支持:重庆聚合科技有限公司 地址:成都市人民南路四段55号