| Autor: |
Giovanni Fattori, Jan Hrbacek, Harald Regele, Christian Bula, Alexandre Mayor, Stefan Danuser, David C. Oxley, Urs Rechsteiner, Martin Grossmann, Riccardo Via, Till T. Böhlen, Alessandra Bolsi, Marc Walser, Michele Togno, Emma Colvill, Daniel Lempen, Damien C. Weber, Antony J. Lomax, Sairos Safai |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Zeitschrift für Medizinische Physik, Vol 32, Iss 1, Pp 52-62 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
0939-3889 |
| DOI: |
10.1016/j.zemedi.2020.07.001 |
| Popis: |
We present the commissioning and quality assurance of our clinical protocol for respiratory gating in pencil beam scanning proton therapy for cancer patients with moving targets. In a novel approach, optical tracking has been integrated in the therapy workflow and used to monitor respiratory motion from multiple surrogates, applied on the patients’ chest. The gating system was tested under a variety of experimental conditions, specific to proton therapy, to evaluate reaction time and reproducibility of dose delivery control. The system proved to be precise in the application of beam gating and allowed the mitigation of dose distortions even for large (1.4 cm) motion amplitudes, provided that adequate treatment windows were selected. The total delivered dose was not affected by the use of gating, with measured integral error within 0.15 cGy. Analysing high-resolution images of proton transmission, we observed negligible discrepancies in the geometric location of the dose as a function of the treatment window, with gamma pass rate greater than 95% (2%/2 mm) compared to stationary conditions. Similarly, pass rate for the latter metric at the 3%/3 mm level was observed above 97% for clinical treatment fields, limiting residual movement to 3 mm at end-exhale. These results were confirmed in realistic clinical conditions using an anthropomorphic breathing phantom, reporting a similarly high 3%/3 mm pass rate, above 98% and 94%, for regular and irregular breathing, respectively. Finally, early results from periodic QA tests of the optical tracker have shown a reliable system, with small variance observed in static and dynamic measurements. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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