Intensity-modulated radiotherapy dose validation based on real respiratory motion parameters in lung cancer patients

CHEN Hua; SHAO Yan; WANG Hao; GU Hengle; DUAN Yanhua; FENG Aihui; HUANG Ying; LIN Yang; SHEN Zhenjiong; XU Zhiyong

doi:10.11889/j.1000-3436.2022-0111

您当前的位置：

首页 >

文章列表页 >

Intensity-modulated radiotherapy dose validation based on real respiratory motion parameters in lung cancer patients

RADIOBIOLOGY AND RADIOMEDICINE | 更新时间：2023-06-21

- Intensity-modulated radiotherapy dose validation based on real respiratory motion parameters in lung cancer patients
- Journal of Radiation Research and Radiation Processing Vol. 41, Issue 3, Pages: 30302(2023)
- 作者机构：
  
  1.上海市胸科医院/上海交通大学医学院附属胸科医院上海 200030
- 作者简介：
  
  CHEN Hua (female) was born in June 1986, and obtained her doctoral degree from Fudan University in 2023. Now she works at the Department of Radiation Oncology of Shanghai Chest Hospital as a medical physicist, majoring in effect of respiratory motion on chest tumors
  XU Zhiyong, professor, E-mail: xzyong12vip@sina.com
- 基金信息：
  
  Nature projects for basic research of Shanghai Chest Hospital(2021YNJCQ11)
- DOI：10.11889/j.1000-3436.2022-0111
  CLC：
扫描看全文
CHEN Hua, SHAO Yan, WANG Hao, et al. Intensity-modulated radiotherapy dose validation based on real respiratory motion parameters in lung cancer patients. [J]. Journal of Radiation Research and Radiation Processing 41(3):030302(2023)
DOI：

CHEN Hua, SHAO Yan, WANG Hao, et al. Intensity-modulated radiotherapy dose validation based on real respiratory motion parameters in lung cancer patients. [J]. Journal of Radiation Research and Radiation Processing 41(3):030302(2023) DOI： 10.11889/j.1000-3436.2022-0111.

摘要

回顾性分析在上海市胸科医院已接受调强放射治疗（IMRT）的27例肺癌患者，根据四维CT（4DCT）图像获取患者自由呼吸运动状态下肿瘤在三维方向上的运动幅度及周期。基于以上呼吸运动参数，借助呼吸运动平台测量肿瘤在头脚和左右方向上呼吸运动状态下的剂量分布，采用二维γ分析方法比较呼吸运动状态和静止状态的剂量分布差异，并分析呼吸运动对患者实际治疗时剂量验证的影响。患者平均呼吸运动周期为3.3 s，头脚方向上平均肿瘤运动幅度（5.6 mm）大于左右方向（2.1 mm）和前后方向（2.3 mm），且最大为18 mm。头脚和左右方向的呼吸运动状态下的γ通过率都低于静止状态的γ通过率（,p,<,0.001），且都随肿瘤运动幅度的增加呈逐渐减小趋势，当肿瘤运动幅度大于3 mm时，绝大多数γ通过率小于95%。按呼吸周期中位数分组后，左右方向上的运动状态下两组的γ通过率差异具有统计学意义。肿瘤运动幅度是影响肺癌IMRT剂量验证的主要因素，呼吸运动周期也影响剂量验证。对于呼吸运动幅度较大的患者建议采用呼吸运动管理技术以提高靶区剂量递送的准确性。

Abstract

To assess the effect of respiratory movement on dose distribution via intensity-modulated radiotherapy (IMRT) in patients with lung cancer based on real respiratory movement parameters. Twenty-seven patients with lung cancer who underwent four-dimensional computed tomography (4DCT) and received IMRT were analyzed retrospectively to determine the three-dimensional tumor motion amplitude and respiratory period. Based on the above movement parameters, the dose distribution of the tumor on the respiratory movement platform in the head-foot and left-right directions was measured. The difference in IMRT dose distribution between the respiratory motion and static states was compared using the two-dimensional gamma analysis method, and the effect of respiratory motion on dose verification was analyzed. The mean respiratory motion period of patients was 3.3 s, and the mean tumor motion amplitude in the head-foot direction (5.6 mm) was greater than that in the left-right direction (2.1 mm) and the anterior-posterior direction (2.3 mm), with the maximum at 18 mm. The γ-passage rate tended to decrease gradually with the increase intumor motion amplitude. When the tumor motion amplitude was greater than 3 mm, the γ passage rate was less than 95% in most beams. The differences of γ-passage rates grouped by the median respiratory period were statistically significant in the left-right directional motion state. IMRT dose validation in lung canceris affected by the amplitude of tumor motion and the respiratory motion cycle. Respiratory motion management techniques are recommended for patients with a large respiratory motion amplitude to improve the accuracy of dose delivery to the target.

关键词

剂量验证呼吸运动模型肺癌IMRT治疗计划γ分析

Keywords

Dose validationRespiratory motion modelLung cancerIMRT treatment planningGamma analysis

references

刘苓苓, 费振乐, 李兵兵, 等. 呼吸运动幅度对静态IMRT剂量分布的影响研究[J]. 中华放射肿瘤学杂志, 2016, 25(5): 508-512. DOI: 10.3760/cma.j.issn.1004-4221.2016.05.019http://dx.doi.org/10.3760/cma.j.issn.1004-4221.2016.05.019.

LIU Lingling, FEI Zhenyue, LI Bingbing, et al. Effect of amplitude of respiratory movements on dose distribution of static intensity-modulated radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 508-512. DOI: 10.3760/cma.j.issn.1004-4221.2016.05.019http://dx.doi.org/10.3760/cma.j.issn.1004-4221.2016.05.019.

吴先想, 牛振洋, 费振乐, 等. 呼吸运动状态对动态调强放疗剂量分布影响的研究[J]. 中华放射医学与防护杂志, 2019, 39(3): 197-201. DOI: 10.3760/cma.j.issn.0254-5098.2019.03.007http://dx.doi.org/10.3760/cma.j.issn.0254-5098.2019.03.007.

WU Xianxiang, NIU Zhenyang, FEI Zhenyue, et al. The effect of respiratory motion states on dynamic IMRT dose distribution[J]. Chinese Journal of Radiological Medicine and Protection, 2019, 39(3): 197-201. DOI: 10.3760/cma.j.issn.0254-5098.2019.03.007http://dx.doi.org/10.3760/cma.j.issn.0254-5098.2019.03.007.

Xie K, Sun H F, Lin T, et al. IMRT dose verification considering passing rate and respiratory motion[J]. Oncology Letters, 2018, 16(1): 963-969. DOI: 10.3892/ol.2018.8724http://dx.doi.org/10.3892/ol.2018.8724.

张英杰, 李建彬, 田世禹, 等. 基于四维CT对肺癌原发灶位移和体积变化相关性研究[J]. 中华放射肿瘤学杂志, 2011, 20(6): 513-516. DOI: 10.3760/cma.j.issn.1004-4221.2011.06.019http://dx.doi.org/10.3760/cma.j.issn.1004-4221.2011.06.019.

ZHANG Yingjie, LI Jianbin, TIAN Shiyu, et al. A correlation study on position and volume variation of primary lung cancer during respiration by four-dimensional CT[J]. Chinese Journal of Radiation Oncology, 2011, 20(6): 513-516. DOI: 10.3760/cma.j.issn.1004-4221.2011.06.019http://dx.doi.org/10.3760/cma.j.issn.1004-4221.2011.06.019.

Shang D P, Yue J B, Li J B, et al. Comparison of different width detector on the gross tumor volume delineation of the solitary pulmonary lesion[J]. Journal of Cancer Research and Therapeutics, 2017, 13(4): 693-698. DOI: 10.4103/jcrt.JCRT_1448_16http://dx.doi.org/10.4103/jcrt.JCRT_1448_16.

George R, Vedam S S, Chung T D, et al. The application of the sinusoidal model to lung cancer patient respiratory motion[J]. Medical Physics, 2005, 32(9): 2850-2861. DOI: 10.1118/1.2001220http://dx.doi.org/10.1118/1.2001220.

Ross C S, Hussey D H, Pennington E C, et al. Analysis of movement of intrathoracic neoplasms using ultrafast computerized tomography[J]. International Journal of Radiation Oncology * Biology * Physics, 1990, 18(3): 671-677. DOI: 10.1016/0360-3016(90)90076-Vhttp://dx.doi.org/10.1016/0360-3016(90)90076-V.

Mechalakos J, Yorke E, Mageras G S, et al. Dosimetric effect of respiratory motion in external beam radiotherapy of the lung[J]. Radiotherapy and Oncology, 2004, 71(2): 191-200. DOI: 10.1016/j.radonc.2004. 01.011http://dx.doi.org/10.1016/j.radonc.2004.01.011.

肖锋, 谭丽娜, 孙晓欢, 等. 呼吸运动对肺癌动态调强放疗剂量分布的影响[J]. 现代肿瘤医学, 2012, 20(3): 608-611. DOI: 10.3969/j.issn.1672-4992.2012.03.53http://dx.doi.org/10.3969/j.issn.1672-4992.2012.03.53.

XIAO Feng, TAN Lina, SUN Xiaohuan, et al. Influence of respiratory motion on the dose distribution in dynamic intensity ─ modulated radiotherapy for lung cancer[J]. Journal of Modern Oncology, 2012, 20(3): 608-611. DOI: 10.3969/j.issn.1672-4992.2012.03.53http://dx.doi.org/10.3969/j.issn.1672-4992.2012.03.53.

李鑫, 李坚, 卢建杰, 等. 呼吸运动模式对胸部肿瘤SBRT剂量分布影响的研究[J]. 肿瘤预防与治疗, 2022, 35(1): 36-42. 10.3969/j.issn.1674-0904.2022.01.006http://dx.doi.org/10.3969/j.issn.1674-0904.2022.01.006

LI Xin, LI Jian, LU Jianjie, et al. Effect of respiratory movement patterns on dose distribution of SBRT in thoracic tumors[J]. Journal of Cancer Control and Treatment, 2022, 35(1): 36-42. 10.3969/j.issn.1674-0904.2022.01.006http://dx.doi.org/10.3969/j.issn.1674-0904.2022.01.006

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Dose distribution alignment method based on rigid registration

LIG4及HSPB1基因单核苷酸多态性与肺癌放射性肺损伤的相关性研究

Related Author

No data

Related Institution

Hefei Institutes of Physical Science， Chinese Academy of Sciences

University of Science and Technology of China

The First Affiliated Hospital of University of Science and Technology of China

1(Department of Radiation Oncology, the Fourth Affiliated Hospital of China Medical University,,)

2(Department of Radiation Oncology, the First Affiliated Hospital of China Medical University,,)

⁰