高剂量率前列腺近距离治疗工作流程中的治疗计划质量概览。

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-11-01 DOI:10.1016/j.brachy.2024.08.255

J.V. Panetta, I. Veltchev, E. Horwitz, M. Hallman, K. Wong, R.A. Price, C.M.C. Ma

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引用次数: 0

摘要

目的：高剂量率近距离放射治疗（HDR-BT）已被证明是治疗前列腺癌的有效方法，但治疗计划的质量取决于多种因素。在这项工作中，我们报告了基于超声（US）的工作流程的整体性能以及几个特定治疗变量的影响：本研究选取了 2021 年至 2023 年期间使用瓦里安 Bravos/US 接受 HDR-BT（增强、单次治疗和再治疗）治疗的患者作为样本。对治疗计划的质量进行了分析，并根据一系列指标对计划进行了分类，包括：前列腺体积、主治医生、计划物理学家、包含的针数、预计计划时间、直肠-前列腺分离和膀胱-前列腺分离。该程序的性能与我们使用以前使用过的模式组合的程序性能进行了比较：结果：结果表明，我们的 Bravos/US 工作流程的计划质量始终高于所有相关人员的可接受标准；平均而言：前列腺 V100%：98.9% ± 0.1%，直肠 V75%：0.04 ± 0.01 cc，膀胱 V75%：0.06 ± 0.01cc，尿道 V125%：0.00 ± 0.00 cc。与我们之前使用的模式相比，该工作流程在统计学上提高了前列腺的覆盖率。在统计上，高危器官拼接/前列腺覆盖率与前列腺体积、针数/前列腺体积、膀胱-前列腺分离度和直肠-前列腺分离度之间存在相关性。计划质量与计划时间之间没有相关性：结论：我们基于美国的 HDR-BT 计划的目标覆盖率和风险器官疏通率均超过了相关部门的要求。无论参与的人员如何，结果都是可以接受的，而且使用更多的针/前列腺体积以及增加前列腺与直肠和膀胱之间的间距可以提高计划质量。

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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Overview of treatment plan quality in a high dose rate prostate brachytherapy workflow

PURPOSE

High dose rate brachytherapy (HDR-BT) has been shown to be an effective treatment for prostate cancer, with treatment plan quality dependent on a number of factors. In this work, we report on the overall performance of our ultrasound (US)-based workflow and the impact of several treatment-specific variables.

METHODS AND MATERIALS

Patients who underwent HDR-BT (boost, monotherapy, and retreatment) using Varian Bravos/US from 2021 to 2023 were sampled for this study. Treatment plan quality was analyzed and plans were categorized with regard to a number of metrics, including: prostate volume, treating physician, planning physicist, number of needles included, estimated planning time, rectum-prostate separation, and bladder-prostate separation. The performance of this program was compared to the performance of our program using previously used modality combinations: Varian Varisource/US, Elekta microSelectron/CT.

RESULTS

Plan quality for our Bravos/US workflow was shown to be consistently above acceptability criteria for all personnel involved; on average: prostate V100%: 98.9% ± 0.1%, rectum V75%: 0.04 ± 0.01 cc, bladder V75%: 0.06 ± 0.01cc, urethra V125%: 0.00 ± 0.00 cc. Prostate coverage was statistically improved with this workflow compared to that using our previous modalities. There was a statistical correlation between organ-at-risk sparing/prostate coverage ratio and prostate volume, number of needles/prostate volume, bladder-prostate separation, and rectum-prostate separation. There was no correlation between plan quality and planning time.

CONCLUSIONS

Our US-based HDR-BT program led to target coverage and organ-at-risk sparing that exceeded department thresholds. Results were acceptable regardless of the personnel involved and improved plan quality was obtained using more needles/prostate volume and increased spacing between the prostate and the rectum and bladder.

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.