Purpose: To develop a workflow for systemically reviewing the doses received by organs at risk (OARs) in a BgRT treatment session, as a means of monitoring delivery constancy and possibly identifying changes of clinical concern in the patient.Methods: We implemented a workflow consisting of a qualitative review of the reconstructed delivered-dose information provided by the RefleXion system, followed by its quantitative evaluation using in-house software. For the latter we developed a framework for calculating custom OAR dose–volume metrics from the delivered-dose distribution and graphing them. We retrospectively applied our workflow to three select BgRT patient cases to appraise its clinical utility.Results: Our workflow efficiently incorporates existing RefleXion TPS features and in-house software into a process for thoroughly evaluating doses to OARs after BgRT delivery. The spreadsheet we created for graphing the trends of normalized OAR dose–volume metrics readily shows if OAR doses have significantly changed or tolerance limits have been violated, thereby potentially revealing if changes of concern occurred in the targeted region. Our workflow also yields a cumulative delivered-dose record at the end of treatment.Conclusions: We established a post-BgRT dose evaluation workflow which supplements the information provided by RefleXion with calculation and graphing of custom OAR dose–volume metrics. This workflow is now routinely used in our clinic following all BgRT treatments. Future improvements could include increased automation, updating the dose calculation to reflect changes in patient anatomy, incorporation of PET metrics, and consideration of target dose data.
目的：建立一种系统评估BgRT治疗中危及器官（OARs）受照剂量的工作流程，以监测治疗实施的稳定性，并可能识别患者出现的临床关注变化。 方法：我们构建的工作流程包括对RefleXion系统提供的重建实施剂量信息进行定性评估，随后使用自主研发软件进行定量分析。在定量评估环节，我们开发了从实施剂量分布中计算定制OAR剂量-体积指标并生成可视化图谱的框架。通过回顾性分析三例精选BgRT患者病例，评估该工作流程的临床实用性。 结果：本工作流程有效整合了RefleXion治疗计划系统现有功能与自主研发软件，形成BgRT治疗后OAR受照剂量的全面评估体系。通过我们创建的归一化OAR剂量-体积指标趋势图表，可直观显示OAR剂量是否发生显著变化或超出耐受限值，从而提示靶区是否出现需要关注的改变。该流程还能在治疗结束时生成累积实施剂量记录。 结论：我们建立的BgRT后剂量评估工作流程，通过计算和可视化定制OAR剂量-体积指标，对RefleXion系统提供的信息进行了有效补充。该流程目前已作为常规程序应用于我院所有BgRT治疗后评估。未来改进方向包括：提升自动化程度、根据患者解剖结构变化更新剂量计算、整合PET指标参数，以及纳入靶区剂量数据分析。
肿瘤(癌症)患者之家