PDF(Pubmed)
Abstract：
BACKGROUND: Radiotherapy plays a key role as an adjuvant treatment in pediatric Wilm\'s tumor, improving both survival and quality of life. The success of radiotherapy depends on the precise delivery of radiation dose to the tumor while sparing radiosensitive structures in the vicinity of the tumor. Pediatric patients pose unique challenges in achieving accurate radiotherapy delivery due to their inability to understand instructions and the high radiosensitivity of their tissues. Thus, it is important to determine the optimum geometric verification strategy that will ensure accurate delivery of the prescribed target as specified in the patient\'s treatment plan.
OBJECTIVE: To evaluate the performance of an offline geometric correction strategy in ensuring accuracy and reproducibility during radiotherapy delivery in Wilm\'s tumor patients.
METHODS: The extended no-action level offline correction strategy was applied in the radiotherapy delivery of 45 Wilm\'s tumor patients. Gross errors from the first three fractions were used to calculate the mean errors which were then applied as offline correction factors. Mean errors among different groups were compared using a two-way analysis of variance (ANOVA) and Dunnett\'s pairwise comparisons. All statistical analyses and data visualization were performed using GraphPad Prism version 7 (Insight Partners, GraphPad Holdings, LLC).
RESULTS: A total of 45 patients were included in the study. In all three orthogonal directions, the recorded gross errors were significantly lower after the application of the systematic error corrections. Random errors were significantly larger in the longitudinal direction compared to lateral (mean difference = 0.28, p = 0.036) and vertical directions (mean difference = 0.37 cm, p = 0.003). Patients\' age was a significant predictor of random errors whereby the magnitude of random error decreased with increasing age.
CONCLUSIONS: This study shows that the offline correction strategy used is effective in ensuring the accuracy of radiotherapy delivery in pediatric Wilm\'s tumor patients.
OBJECTIVE: To evaluate the performance of an offline geometric correction strategy in ensuring accuracy and reproducibility during radiotherapy delivery in Wilm\'s tumor patients.
METHODS: The extended no-action level offline correction strategy was applied in the radiotherapy delivery of 45 Wilm\'s tumor patients. Gross errors from the first three fractions were used to calculate the mean errors which were then applied as offline correction factors. Mean errors among different groups were compared using a two-way analysis of variance (ANOVA) and Dunnett\'s pairwise comparisons. All statistical analyses and data visualization were performed using GraphPad Prism version 7 (Insight Partners, GraphPad Holdings, LLC).
RESULTS: A total of 45 patients were included in the study. In all three orthogonal directions, the recorded gross errors were significantly lower after the application of the systematic error corrections. Random errors were significantly larger in the longitudinal direction compared to lateral (mean difference = 0.28, p = 0.036) and vertical directions (mean difference = 0.37 cm, p = 0.003). Patients\' age was a significant predictor of random errors whereby the magnitude of random error decreased with increasing age.
CONCLUSIONS: This study shows that the offline correction strategy used is effective in ensuring the accuracy of radiotherapy delivery in pediatric Wilm\'s tumor patients.
摘要：
背景：放射治疗在小儿Wilm's肿瘤的辅助治疗中起着关键作用，提高生存和生活质量。放射治疗的成功取决于将辐射剂量精确地传递到肿瘤，同时保留肿瘤附近的辐射敏感结构。儿科患者由于无法理解指令和其组织的高放射敏感性，在实现准确的放射治疗方面面临着独特的挑战。因此，重要的是要确定最佳的几何验证策略，以确保患者治疗计划中指定的规定目标的准确交付。
目的：评估离线几何校正策略在确保Wilm\'s肿瘤患者放疗期间的准确性和可重复性方面的性能。
方法：在45例Wilm\'s肿瘤患者的放疗中应用了扩展无作用水平离线矫正策略。来自前三个部分的粗差用于计算平均误差，然后将其用作离线校正因子。使用双向方差分析（ANOVA）和Dunnett的成对比较来比较不同组之间的平均误差。所有统计分析和数据可视化均使用GraphPadPrism版本7(InsightPartners，GraphPad控股公司，LLC).
结果：共45例患者纳入研究。在所有三个正交方向上，应用系统误差校正后，记录的粗差显著降低。与横向（平均差=0.28，p=0.036）和垂直方向（平均差=0.37cm，p=0.003)。患者年龄是随机误差的重要预测指标，随机误差的大小随着年龄的增长而降低。
结论：这项研究表明，所使用的离线矫正策略可有效确保小儿Wilm's肿瘤患者放疗的准确性。
目的：评估离线几何校正策略在确保Wilm\'s肿瘤患者放疗期间的准确性和可重复性方面的性能。
方法：在45例Wilm\'s肿瘤患者的放疗中应用了扩展无作用水平离线矫正策略。来自前三个部分的粗差用于计算平均误差，然后将其用作离线校正因子。使用双向方差分析（ANOVA）和Dunnett的成对比较来比较不同组之间的平均误差。所有统计分析和数据可视化均使用GraphPadPrism版本7(InsightPartners，GraphPad控股公司，LLC).
结果：共45例患者纳入研究。在所有三个正交方向上，应用系统误差校正后，记录的粗差显著降低。与横向（平均差=0.28，p=0.036）和垂直方向（平均差=0.37cm，p=0.003)。患者年龄是随机误差的重要预测指标，随机误差的大小随着年龄的增长而降低。
结论：这项研究表明，所使用的离线矫正策略可有效确保小儿Wilm's肿瘤患者放疗的准确性。
