scholarly journals A Probability Approach to the Study on Uncertainty Effects on Gamma Index Evaluations in Radiation Therapy

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Francisco Cutanda Henríquez ◽  
Silvia Vargas Castrillón

Two datasets of points of known spatial positions and an associated absorbed dose value are often compared for quality assurance purposes in External Beam Radiation Therapy (EBRT). Some problems usually arise regarding the pass fail criterion to accept both datasets as close enough for practical purposes. Instances of this kind of comparisons are fluence or dose checks for intensity modulated radiation therapy, modelling of a treatment unit in a treatment planning system, and so forth. The gamma index is a figure of merit that can be obtained from both datasets; it is widely used, as well as other indices, as part of a comparison procedure. However, it is recognized that false negatives may take place (there are acceptable cases where a certain number of points do not pass the test) due in part to computation and experimental uncertainty. This work utilizes mathematical methods to analyse comparisons, so that uncertainty can be taken into account. Therefore, false rejections due to uncertainty do not take place and there is no need to expand tolerances to take uncertainty into account. The methods provided are based on the rules of uncertainty propagation and help obtain rigorous pass/fail criteria, based on experimental information.

Author(s):  
Khamis Amour ◽  
Dr. Khamza Maunda ◽  
Dr. Mohamed Mazunga ◽  
Dr. Peane Maleka ◽  
Professor Peter Msaki

Although External Beam Radiation Therapy (EBRT) is essential tool for the radiation therapy of cervical cancer; only one cancer institute in Tanzania performs 3-Dimensional Conformal Radiation Therapy (3DCRT) Computed Tomography (CT)-based planning. To identify benefits and advantages of 3D-CRT over 2D- conventional radiation therapy (2D-CRT), dosimetric parameters for tumor targets and organs at risk (OARs) were compared between these modalities for 23 cervical cancer patients. 11 cervical cancer patients were CT scanned after proper positioning and immobilization and transferred to Eclipse Treatment Planning System (TPS) for dose planning. The remaining 12 curative intent patients were planned using 2D-CRT system and treatment times were calculated for each patient. From the CT based planning, the minimum dose (D min), maximum dose (D max) and mean dose (D mean) to Planning Target Volume (PTV) and organs at risk (OAR), were compared for each plan. On average, the optimized maximum doses for bladder, rectum, femoral heads, PTV and Gross Tumor Volume (GTV) were 46.56 Gy, 42.65 Gy, 28.76 Gy, 48.56 Gy and 48.53 Gy. For 2D-concentional planning, the dose rate was 75.75 cGy/min and the average treatment time was 1.6075 minutes. This study confirms that 3D CT-based planning is a good choice in the treatment protocol for carcinoma cervix as it delivered a highly homogeneous and conformal plan with superior dose coverage to PTV and better OARs sparing.


Author(s):  
Alexandros Clouvas ◽  
Anna Makridou ◽  
Michalis Chatzimarkou

The capabilities of electret ion chambers to measure non-target absorbed dose for distances greater than 20 cm from the irradiated volume during radiotherapy treatment was investigated for the first time. During radiotherapy, nontarget doses can be classified as one of three approximate dose levels: high doses, intermediate doses and low doses. Low doses (<5 % of the prescription dose) are not generally considered during treatment planning, due to the fact that is difficult to measure, characterize, or model them in the planning system. In this work were performed measurements with electret ion chambers of absorbed dose outside the treated volume (<5 % of the prescription dose), during external photon radiation therapy in an Elekta Infinity Linear Accelerator of ?Theagenio? Cancer Hospital of Thessaloniki, Greece. The absorbed dose values for distances greater than 20 cm from the irradiated volume varied from 0.3 to 17 mGy which corresponds to 0.01% up to 0.6% of the prescription dose (2660 mGy). Near the irradiation volume the absorbed dose values were greater than the upper detection limit of the electret ion chambers (threshold 40 mGy). The results are compared with the calculated ones by the Monaco Treatment Planning System (Elekta Monaco 5.11.03). In the non-target radiation region where Monaco Treatment Planning System calculates rather precisely (within uncertainties of less than 10%) the absorbed dose, measured and calculated doses are the same within experimental uncertainties. On the contrary, when leakage radiation becomes the dominant source of out-of-field dose the differences are up to 31%.


2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 37-41 ◽  
Author(s):  
William F. Regine ◽  
Roy A. Patchell ◽  
James M. Strottmann ◽  
Ali Meigooni ◽  
Michael Sanders ◽  
...  

Object. This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT). Methods. Eighteen patients with previously unirradiated, gliomas treated between March 1995 and January 2000 form the substrate of this report. These included 11 patients with malignant gliomas, six with low-grade gliomas, and one with a recurrent glioma. They were stratified into three groups according to tumor volume (TV). Fifteen were treated using the initial FSRS dose schedule and form the subject of this report. Group A (four patients), had TV of 5 cm3 or less (7 Gy twice pre- and twice post-CEBRT); Group B (six patients), TV greater than 5 cm3 but less than or equal to 15 cm3 (7 Gy twice pre-CEBRT and once post-CEBRT); and Group C (five patients), TV greater than 15 cm3 but less than or equal to 30 cm3 (7 Gy once pre- and once post-CEBRT). All patients received CEBRT to 59.4 Gy in 1.8-Gy fractions. Dose escalation was planned, provided the level of toxicity was acceptable. All patients were able to complete CEBRT without interruption or experiencing disease progression. Unacceptable toxicity was observed in two Grade 4/Group B patients and two Grade 4/Group C patients. Eight patients required reoperation. In three (38%) there was necrosis without evidence of tumor. Neuroimaging studies were available for evaluation in 14 patients. Two had a partial (≥ 50%) reduction in volume and nine had a minor (> 20%) reduction in size. The median follow-up period was 15 months (range 9–60 months). Six patients remained alive for 3 to 60 months. Conclusions. The imaging responses and the ability of these patients with intracranial gliomas to complete therapy without interruption or experiencing disease progression is encouraging. Excessive toxicity derived from combined FSRS and CEBRT treatment, as evaluated thus far in this study, was seen in patients with Group B and C lesions at the 7-Gy dose level. Evaluation of this novel treatment strategy with dose modification is ongoing.


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