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首頁> 美國衛(wèi)生研究院文獻>Journal of Applied Clinical Medical Physics >Dosimetric and volumetric changes in the rectum and bladder in patients receiving CBCT‐guided prostate IMRT: analysis based on daily CBCT dose calculation
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Dosimetric and volumetric changes in the rectum and bladder in patients receiving CBCT‐guided prostate IMRT: analysis based on daily CBCT dose calculation

機譯：接受CBCT指導(dǎo)的前列腺IMRT的患者直腸和膀胱的劑量和體積變化：基于每日CBCT劑量計算的分析

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Delivered dose can be calculated by transferring the planned treatment beams onto the daily CBCT. Bladder and rectum volumetric doses were calculated and correlated to the daily bladder and rectum fullness. Patients for this study underwent hypofractionated prostate IMRT to 70 Gy in 28 fractions. Daily CBCT was utilized for image guidance. A clinically acceptable plan was created using a CTV‐to‐PTV uniform margin of 5 mm. Image fusion was performed to transfer the bladder and rectum contours onto each CBCT. Contours were then edited to match the anatomy of each CBCT. Using the daily treatment isocenter, the planned beams were transferred onto the CBCT and daily and cumulative DVHs calculated. For the results a total of 168 daily CBCTs were evaluated. The bladder was found to be smaller for 74.7% of the 168 daily CBCTs accessed in this study. This reduction in volume correlated to an increase in the cumulative bladder V70 Gy from 9.47% on the planning CT to 10.99% during treatment. V70Gy for the rectum was 7.27% on the planning CT, when all six patients were averaged, and increased to 11.56% on the average of all daily treatment CBCTs. Increases in volumetric rectum dose correlated with increases in rectal volume. For one patient, the rectum and bladder absolute V70 Gy, averaged over the course of treatment, increased by 295% and 61%, respectively. Larger variations in the daily bladder and rectal volume were observed and these correlated to large deviations from the volumetric dose received by these structures. In summary, bladder and rectum volume changes during treatment have an effect on the cumulative dose received by these organs. It was observed that the volumetric dose received by the bladder decreases as the volume of the bladder increases. The inverse was true for the rectum.PACS number(s): 87.55.dk‐, 87.57.Q‐
機譯：可以通過將計劃的治療束轉(zhuǎn)移到每日CBCT上來計算輸送劑量。計算膀胱和直腸的體積劑量，并將其與每日膀胱和直腸充滿度相關(guān)。這項研究的患者接受了28次分割至70 Gy的超分割前列腺IMRT。每日CBCT用于圖像指導(dǎo)。使用從CTV到PTV的5 mm統(tǒng)一邊距創(chuàng)建了臨床可接受的計劃。進行圖像融合以將膀胱和直腸輪廓轉(zhuǎn)移到每個CBCT上。然后編輯輪廓以匹配每個CBCT的解剖結(jié)構(gòu)。使用每日治療等中心線，將計劃的波束傳輸?shù)紺BCT上，并計算每日和累計DVH。對于結(jié)果，總共評估了每日168次CBCT。在這項研究中，每天發(fā)現(xiàn)的168個CBCT中，膀胱較小，占74.7％。體積減少與治療期間CT上的累積膀胱V70 Gy從9.47％增加到10.99％相關(guān)。計劃的CT上，直腸的V70Gy為7.27％，這是對所有6例患者進行平均計算得出的結(jié)果，而對所有日常CBCT的平均V70Gy上升為11.56％。直腸容積的增加與直腸容積的增加相關(guān)。對于一名患者，在治療過程中平均直腸和膀胱絕對V70 Gy分別增加了295％和61％。觀察到每日膀胱和直腸體積的較大變化，并且這些與與這些結(jié)構(gòu)所接受的體積劑量的較大偏差相關(guān)?？傊?，治療期間膀胱和直腸體積的變化對這些器官所接受的累積劑量有影響。觀察到，隨著膀胱體積的增加，膀胱所接受的體積劑量減小。直腸的倒數(shù)是正確的.PACS編號：87.55.dk‐，87.57.Q‐

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