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相对于被动式束流配送系统,由患者呼吸因素而引起的肿瘤靶区运动会对主动式束流配送系统下的离子束放射治疗带来非常严重的影响,造成离子束辐射场剂量分布的严重畸变,甚至对肿瘤靶区周围的健康组织造成严重损伤,很大程度上影响离子束治疗的疗效。因此,在主动式束流配送系统下,建立针对由呼吸因素引起的运动肿瘤靶区的适形调强照射方法就显得必要,且具有重要意义。系统介绍了呼吸运动探测、4D-CT以及目前主要的3种运动补偿方法(多次扫描、呼吸门控和主动跟踪技术),并对这3种方法在靶区适形度、稳健性以及技术复杂度等方面进行了比较。在靶区适形度方面主动跟踪技术优于门控技术,而门控技术又优于多次扫描技术;在稳健性方面多次扫描技术优于门控技术,而门控技术优于主动跟踪技术;在技术复杂度方面,多次扫描技术最简单,其次是门控技术,而主动跟踪技术最复杂。
Compared with the passive beam delivery system, the tumor target movement caused by respiratory factors of patients will have a very serious impact on the ion beam radiation therapy under the active beam delivery system, resulting in serious distortion of the ion beam radiation field dose distribution, Even serious damage to the healthy tissue around the tumor target area, to a large extent, affect the efficacy of ion beam therapy. Therefore, under the active beam delivery system, it is necessary and significant to establish a method of conformal intensity-modulated radiation targeting the moving tumor target caused by respiratory factors. The system introduces the respiratory motion detection, 4D-CT and the three main methods of motion compensation (multiple scanning, respiratory gating and active tracking), and introduces the three methods of target conformality, robustness and technology Complexity and other aspects were compared. Active tracking is superior to gating in terms of target conformality, while gating is superior to multiple scans; multiple scans are superior to gating in terms of robustness, while gating is superior to active tracking Technology; in terms of technical complexity, scanning technology is the simplest to many times, followed by gating technology, and the most complicated active tracking technology.