Predicted Inferior Outcomes for Lung SBRT With Treatment Planning Systems That Fail Independent Phantom-Based Audits

医学 放射治疗计划 多叶准直器 核医学 成像体模 质量保证 放射治疗 放射科 病理 外部质量评估
作者
Matthew D. Greer,Brandon Koger,M. Glenn,John Kang,Ramesh Rengan,Jing Zeng,Eric Ford
出处
期刊:International Journal of Radiation Oncology Biology Physics [Elsevier BV]
卷期号:115 (5): 1301-1308 被引量:2
标识
DOI:10.1016/j.ijrobp.2022.12.003
摘要

More than 15% of radiation therapy clinics fail external audits with anthropomorphic phantoms conducted by Imaging and Radiation Oncology Core-Houston (IROC-H) while passing other industry-standard quality assurance (QA) tests. We seek to evaluate the predicted effect of such failed plans on outcomes for patients treated with stereotactic body radiation therapy (SBRT) for lung tumors.We conducted a retrospective study of 55 patients treated with SBRT for lung tumors with a prescription biologically equivalent dose (BED)10 ≥100 Gy using a treatment planning system (TPS) that passed IROC-H phantom audits. Sample linear accelerator beam models with introduced errors were commissioned by varying the multileaf collimator leaf-tip offset parameter (ie, dosimetric leaf gap) over the range ±1.0 mm relative to the validated model. These models mimic TPS that pass internal QA measures but fail IROC-H tests. Patient plans were recalculated on sample beam models. The predicted tumor control probability (TCP) and normal tissue complication probability (NTCP) were calculated based on published dose-response models.A leaf-tip offset value of -1.0 mm decreased the fraction of plans receiving a planning treatment volume of BED10 ≥100 Gy from 95% to 27%. This translated to a significant decrease in 2-year TCP of 4.8% (95% CI: 2.0%-5.5%) with a decrease in TCP up to 21%. Conversely, a leaf-tip offset of +1.0 mm resulted in 36% of patients exceeding previously met organs at risk (OAR) constraints, including 2 instances of spinal cord and brachial plexus overdoses and a small increase in chest wall NTCP of 0.7%, (95% CI: 0.5%-0.8%).Simulated treatment plans with modest MLC leaf offsets result in lung SBRT plans that significantly underdose tumor or exceed OAR constraints. These dosimetric endpoints translate to significant detriments in TCP. These simulated plans mimic planning systems that pass internal QA measures but fail independent phantom-based tests, underscoring the need for enhanced quality assurance including external audits of TPS.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
红烧茄子发布了新的文献求助10
刚刚
我不知道该叫啥完成签到,获得积分10
刚刚
欣欣完成签到 ,获得积分10
刚刚
zhouxuefeng发布了新的文献求助10
1秒前
1秒前
qq596完成签到,获得积分10
1秒前
77发布了新的文献求助10
1秒前
科研小卡拉米完成签到,获得积分10
2秒前
林小不脏发布了新的文献求助10
3秒前
呵浅陌完成签到,获得积分10
3秒前
SciGPT应助螺丝老人采纳,获得10
3秒前
Jasper应助Nicoleliz采纳,获得10
4秒前
4秒前
narcol完成签到 ,获得积分10
4秒前
4秒前
愉快西牛完成签到 ,获得积分10
5秒前
无共鸣完成签到,获得积分10
5秒前
5秒前
huoshu完成签到 ,获得积分10
6秒前
脑洞疼应助葫芦瓢采纳,获得10
6秒前
mmssdd发布了新的文献求助10
6秒前
6秒前
7秒前
sdbz001完成签到,获得积分0
8秒前
8秒前
9秒前
亦晗关注了科研通微信公众号
9秒前
lio发布了新的文献求助10
9秒前
9秒前
寒时完成签到,获得积分10
9秒前
LQQ完成签到,获得积分10
10秒前
Dr.miao完成签到,获得积分10
10秒前
xinchengzhu发布了新的文献求助10
11秒前
鸢尾蓝发布了新的文献求助10
11秒前
笑点低薯片完成签到,获得积分10
11秒前
12秒前
12秒前
研友_ZGD9o8发布了新的文献求助10
12秒前
13秒前
iNk应助Shirley采纳,获得10
13秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Social Research Methods (4th Edition) by Maggie Walter (2019) 2390
A new approach to the extrapolation of accelerated life test data 1000
北师大毕业论文 基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 390
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Robot-supported joining of reinforcement textiles with one-sided sewing heads 360
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4009871
求助须知:如何正确求助?哪些是违规求助? 3549812
关于积分的说明 11303839
捐赠科研通 3284342
什么是DOI,文献DOI怎么找? 1810591
邀请新用户注册赠送积分活动 886393
科研通“疑难数据库(出版商)”最低求助积分说明 811406