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Dose comparison according to Smooth Thickness application of Range compensator during proton therapy for brain tumor patient (뇌종양 환자의 양성자 치료 시 Range Compensator의 Smooth Thickness 적용에 따른 선량비교)

  • Kim, Tae Woan;Kim, Dae Woong;Kim, Jae Weon;Jeong, Kyeong Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.139-148
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    • 2016
  • Purpose : Range Compensator used for proton therapy compensates the proton beam dose which delivers to the normal tissues according to the Target's Distal Margin dose. We are going to check the improvement of dose on the target part by comparing the dose of PTV and OAR according to applying in different method of Smooth Thickness of Range Compensator which is used in brain tumor therapy. Materials and Methods : For 10 brain tumor patients taking proton therapy in National Cancer Center, Apply Smooth Thickness applied in Range Compensator in order from one to five by using Compensator Editor of Eclipse Proton Planning System(Version 10.0, Varian, USA). The therapy plan algorithm used Proton Convolution Superposition(version 8.1.20 or 10.0.28), and we compared Dmax, Dmin, Homogeneity Index, Conformity Index and OAR dose around tumor by applying Smooth Thickness in phase. Results : When Smooth Thickness was applied from one to five, the Dmax of PTV was decreased max 4.3%, minimum at 0.8 and average of 1.81%. Dmin increased max 1.8%, min 1.8% and average. Difference between max dose and minimum dose decreased at max 5.9% min 1.4% and average 2.6%. Homogeneity Index decreased average of 0.018 and Conformity Index didn't had a meaningful change. OAR dose decreased in Brain Stem at max 1.6%, min 0.1% and average 0.6% and in Optic Chiasm max 1.3%, min 0.3%, and average 0.5%. However, patient C and patient E had an increase each 0.3% and 0.6%. Additionally, in Rt. Optic Nerve, there was a decrease at max 1.5%, min 0.3%, and average 0.8%, however, patient B had 0.1% increase. In Lt. Optic Nerve, there was a decrease at max 1.8%, min 0.3%, and average 0.7%, however, patient H had 0.4 increase. Conclusion : As Smooth Thickness of Range Compensator which is used as the proton treatment for brain tumor patients is applied in stages, the resolution of Compensator increased and as a result the most optimized amount of proton beam dose can be delivered. This is considered to be able to irradiate the equal amount at PTV and reduce the unnecessary dose applied at OAR to reduce the side effects.

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Development of Geometrical Quality Control Real-time Analysis Program using an Electronic Portal Imaging (전자포탈영상을 이용한 기하학적 정도관리 실시간 분석 프로그램의 개발)

  • Lee, Sang-Rok;Jung, Kyung-Yong;Jang, Min-Sun;Lee, Byung-Gu;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.77-84
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    • 2012
  • Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

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