儿科患者调强放射治疗的治疗前鉴定:有关耐受范围的适当评估

摘要

Objective: The objective of this work was to establish adequate tolerance limits based on a certain defined institutional indices and generate published data presenting our results to the radiotherapy community. Methods: One hundred paediatric patients were treated using 6-MV X-ray beams produced by Siemens ONCOR Expression linear accelerator. The clinical step-and-shoot intensity-modulated radiation therapy (IMRT) treatment plans were designed using KonRad release 2.2.23. For two treatment sites (abdomen, head and neck), the fluence maps generated by the treatment planning system were all delivered for the quality assurance (QA) which included absolute dose verification for all treatment fields, relative dose verification for each treatment field. Results: The 724 fluence maps were analyzed at three different criteria using the gamma index tool. The 3% dose difference of local prescribed dose /3 mm was considered adequate. The passing rate for all fields of all plans always exceeded 70%. The dose differences between the measured and calculated doses ranged from -2.2% to +4% [mean and standard deviation (s): 1.4 ± 1.5] for the abdominal case, and from -3.3% to +5.6% (1.3 ± 1.6) for head and neck case with total confidence limit 0.046 (4.6%). The 14/100 (14%) of the absolute point dose measurements were out of ±3%from the dose predicted by the treatment planning system. Only two cases were below -3%, while 12 cases over +3%. Conclusion: At 3% dose difference of local prescribed dose /3 mm criteria, a 75% passing a gamma criterion and 3% for absolute point dose can be achieved for abdomen and head and neck treatments site. We considered the tolerance limits based on these indices for IMRT QA adequate.