摘要
目的精确评估乳腺癌保乳术后辅助质子放疗患者自由呼吸对质子束流末端截止位置的影响。方法选取20例乳腺癌保乳术后质子放疗患者,照射结束后10 min左右进行PET‐CT扫描,图像在Raystation RV工作站上进行感兴趣区的确定和采样线的抽提,计算同一空间位置的预测感生放射性和由PET采集得到的真实感生放射性之间的空间差异ΔR_(50),将每对采样线的深度误差值ΔR_(50)进行二维转化和束流视野投影。结果20例乳腺癌患者中位随访时间22个月,随访期内未观察到放射性肺炎的发生。20例患者进行了21例次验证,结果显示均匀分布的主视野、副视野的深度误差分别为(-0.75±1.89)mm、(-0.82±2.06)mm,序贯治疗的主视野、副视野深度误差分别为(1.81±1.87)mm、(1.32±1.74)mm,同步加量的主视野、副视野的深度误差分别为(-1.47±1.44)mm、(-1.48±2.11)mm。结论离线PET‐CT在体生物验证结果显示,乳腺癌质子射线的束流末端截止误差在3 mm内,满足临床与物理师对乳腺癌治疗的精度要求。
Objective Patients are breathing freely during adjuvant proton pencil beam radiotherapy after breast conserving surgery.Fluctuation of the thorax may affect the position of the end of the proton beam flow,which needs to be precisely evaluated on a millimeter scale.Methods For 20 patients with breast cancer treated with proton radiotherapy after breast conserving surgery,PET-CT scan was performed approximately 10 min after the end of proton radiotherapy.The images of PET-CT were processed for ROI determination and sampling line(profile)extraction on a Raystation RV workstation to calculate the actual difference between the predicted and real radioactivity from the same spatial location as obtained by PET acquisition R_(50).Then,the differences in the spatial location between the actual process of proton irradiation and the planned process were obtained.Depth difference values for each pair of sampling lines were presented.Results For 20 patients with breast cancer with a median follow-up of 22 months(range 12-46 months),all patients survived at the last follow-up,and no radiation pneumonitis was observed during the follow-up period.Among the verification results of 21 cases,the depth difference of evenly distributed was(-0.75±1.89)mm in the primary field and(-0.82±2.06)mm in the secondary field;The depth difference of sequential treatment was(1.81±1.87)mm in the primary field and(1.32±1.74)mm in the secondary field;The depth difference of synchronous addition in the primary field was(-1.47±1.44)mm,and the depth difference in the secondary field was(-1.48±2.11)mm.Conclusion The results of off-line PET-CT in vivo biological verification show that the accuracy of the dose boundary cut-off was within 3 mm in breast cancer patients,which meets the clinical and physician requirement for the precision in breast cancer treatment.
作者
张福全
洪正善
张建岗
卢艳
盛尹祥子
章青
尤丹
宋少莉
蒋国梁
孙筠
周荣
程竞仪
Zhang Fuquan;Hong Zhengshan;Zhang Jian'gang;Lu Yan;Sheng-Yin Xiangzi;Zhang Qing;You Dan;Song Shaoli;Jiang Guoliang;Sun Yun;Zhou Rong;Cheng Jingyi(Department of Nuclear Medicine,Shanghai Proton and Heavy Ion Center,Shanghai Key Laboratory of Radiation Oncology(20 dz2261000),Shanghai Engineering Research Center of Proton and Heavy Ion Radiation,Shanghai 201315,China;College of Physics,Sichuan University,Chengdu 610065,China;Department of Radiotherapy,Shanghai Proton and Heavy Ion Center,Shanghai Key Laboratory of Radiation Oncology(20 dz2261000),Shanghai Engineering Research Center of Proton and Heavy Ion Radiation,Shanghai 201315,China;Department of Medical Physics,Shanghai Proton and Heavy Ion Center,Shanghai Key Laboratory of Radiation Oncology(20 dz2261000),Shanghai Engineering Research Center of Proton and Heavy Ion Radiation,Shanghai 201315,China;Department of Nuclear Medicine,Fudan University Shanghai Cancer Center/Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2022年第11期1017-1021,共5页
Chinese Journal of Radiation Oncology
基金
上海市卫生和健康委员会科研课题计划(202040279)
上海市自然科学基金(21ZR1460300)。
关键词
质子放疗
离线PET-CT
在体验证
深度验证
Proton radiotherapy
Off-line PET-CT
In vivo verification
Depth verification
