首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >On-line optimization of intraoperative electron beam radiotherapy of the breast
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On-line optimization of intraoperative electron beam radiotherapy of the breast

机译:乳房术中电子束放射治疗的在线优化

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Purpose: To optimize the dose delivery to the breast lumpectomy target treated with intraoperative electron beam radiotherapy (IOERT). Materials and methods: Two tools have been developed in our MU calculation software NEMO X to improve the dose homogeneity and the in-vivo dosimetry effectiveness for IOERT treatments. Given the target (tumor bed) thickness measured by the surgeon, NEMO X can provide auto dose normalization to cover 95% of the target volume with 95% of the prescription dose (PD) and a "best guess" of the expected dosimeter dose (EDD) for a deep seated in-vivo dosimeter. The tools have been validated with the data of 91 patients treated with IOERT on a LIAC mobile accelerator. In-vivo dosimetry has been performed with microMOSFETs positioned on the shielding disk inserted between the tumor bed and the chest wall. Results: On average the auto normalization showed to provide better results if compared to conventional normalization rules in terms of mean target dose (|MTD-PD|/PD ≤ 5% in 95% vs. 53% of pts) and V107 percentage (〈V107〉 = 19% vs. 32%). In-vivo dosimetry MOSFET dose (MD) showed a better correlation with the EDD guessed by our tool than just by assuming that EDD = PD (|MD-EDD|/EDD ≤ 5% in 57 vs. 26% of pts). Conclusions: NEMO X provides two useful tools for the on-line optimization of the dose delivery in IOERT. This optimization can help to reduce unnecessary large over-dosage regions and allows introducing reliable action levels for in-vivo dosimetry.
机译:目的:为了优化向术中电子束放射治疗(IOERT)治疗的乳房肿块切除术目标的剂量输送。材料和方法:在我们的MU计算软件NEMO X中开发了两种工具,以改善IOERT治疗的剂量均一性和体内剂量学有效性。给定外科医生测量的目标(肿瘤床)厚度,NEMO X可以提供自动剂量归一化,以95%的处方剂量(PD)和预期剂量计剂量的“最佳猜测”覆盖95%的目标体积( EDD)用于深层体内剂量计。该工具已通过在LIAC移动加速器上接受IOERT治疗的91位患者的数据进行了验证。体内剂量测定是通过将​​微型MOSFET置于插入肿瘤床和胸壁之间的屏蔽盘上进行的。结果:与平均归一化规则相比,平均归一化剂量(| MTD-PD | / PD≤5%,分别为95%和53%的患者)和V107百分比(〈 V107> = 19%对32%)。体内剂量MOSFET剂量(MD)与我们的工具猜测的EDD表现出更好的相关性,而不仅仅是假设EDD = PD(57中的MD-EDD | / EDD≤5%,而pts为26%)。结论:NEMO X为在线优化IOERT中的剂量提供了两个有用的工具。这种优化可以帮助减少不必要的大剂量区域,并允许引入体内剂量的可靠作用水平。

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