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IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2024-09-15 DOI:10.1016/j.radonc.2024.110541

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引用次数: 0

摘要

背景和目的我们的目标是开发一个工作流程，自动评估所有乳腺癌患者每日锥形束计算机断层扫描（CBCT）的投放剂量，以评估解剖变化对剂量学的影响，并指导离线计划调整的决策。将计划 CT 注册到 CBCT 上，以创建合成 CT 和传播轮廓。进行前向剂量计算，提取 DVH 参数并打印成报告。我们对该工作流程进行了分组评估，并对 30 名患者的子集进行了患者特异性评估，包括与 10 名患者的额外规划 CT 临床评估进行比较。在 97% 的患者中，乳腺临床目标体积 V95% 的中位数≥ 95%。在半数病例中，额外的计划 CT 与临床决定存在值得商榷的分歧，因此工作流程本可为决定是否需要调整计划提供更多有用的见解。工作流程还发现了临床程序中未识别出的次优覆盖病例。我们已经证明了该工作流程的潜力，它可以帮助对解剖结构不断变化的患者进行计划调整决策，还可以突出显示可能接受次优治疗的患者，并需要对治疗质量进行更密切的临床评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Automated dose evaluation on daily cone-beam computed tomography for breast cancer patients

Background and purpose

Our goal was to develop a workflow to automatically evaluate delivered dose on daily cone beam computed tomography (CBCT) in all breast cancer patients to assess dosimetric impact of anatomical changes and guide decision-making for offline plan adaptation.

Materials and methods

The workflow automatically processes the daily CBCTs of all breast cancer patients receiving local and locoregional radiotherapy. The planning-CT is registered to the CBCT to create a synthetic CT and propagate contours. A forward dose calculation is performed, and DVH parameters are extracted and printed in a report. We evaluated the workflow on a group level and in a subset of 30 patients on a patient-specific level, including comparison to clinical evaluation on additional planning-CT in 10 patients.

Results

7454 fractions in 647 patients were analyzed over a period of seven months. Median breast clinical target volume V95% was ≥ 95 % for 97 % of the patients. The workflow would have provided useful additional insights for decision-making for the requirement of plan adaptation, based on debatable disagreement with the clinical decision in half of the cases with an additional planning-CT. The workflow also identified cases with suboptimal coverage not identified in the clinical procedure.

Conclusion

We developed a fully automated workflow for dose evaluation on daily CBCT for local and locoregional breast radiotherapy. We have demonstrated its potential for aiding decision-making for plan adaptation in patients with changing anatomy and its capability to highlight patients that may receive suboptimal treatment and require closer clinical evaluation of treatment quality.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.