WO2017081768A1 - Appareil de thérapie par faisceau de particules et procédé de correction de plan de traitement - Google Patents

Appareil de thérapie par faisceau de particules et procédé de correction de plan de traitement Download PDF

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WO2017081768A1
WO2017081768A1 PCT/JP2015/081731 JP2015081731W WO2017081768A1 WO 2017081768 A1 WO2017081768 A1 WO 2017081768A1 JP 2015081731 W JP2015081731 W JP 2015081731W WO 2017081768 A1 WO2017081768 A1 WO 2017081768A1
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particle beam
dose
measurement
dose distribution
particle
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PCT/JP2015/081731
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English (en)
Japanese (ja)
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裕介 坂本
西沢　博志
真照 林
哲史 東
山本　和男
有希子 平野
奈津子 前田
保人 岸井
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三菱電機株式会社
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Priority to PCT/JP2015/081731 priority Critical patent/WO2017081768A1/fr
Priority to JP2017549916A priority patent/JP6444532B2/ja
Priority to TW105117949A priority patent/TWI600451B/zh
Publication of WO2017081768A1 publication Critical patent/WO2017081768A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy

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  • the present invention is a particle beam treatment apparatus for performing treatment by irradiating a diseased site such as a tumor with a particle beam (particle beam) such as protons or carbon ions, and applying a predetermined dose according to the three-dimensional shape of the particle beam.
  • a particle beam particle beam
  • the present invention relates to a particle beam therapy apparatus used for irradiation.
  • Particle beam therapy uses a device such as an accelerator to accelerate charged particles such as protons or carbon ions to several hundred mega-electron volts, and irradiates the patient to give a dose to the tumor in the body to treat cancer. It is a method to do. At this time, it is important to form a dose distribution instructed by the doctor, that is, a dose distribution as close as possible to the target distribution for the tumor.
  • the three-dimensional dose distribution in the object has a characteristic that the dose has a maximum peak at one point.
  • This maximum dose peak is called the Bragg peak.
  • the peak position is defined as the “irradiation position” of the particle beam.
  • One of the methods for forming the target distribution is the scanning irradiation method.
  • a mechanism for arbitrarily deflecting the particle beam in two directions perpendicular to the Z direction, that is, the traveling direction of the particle beam, that is, the X and Y directions, using an electromagnet or the like is used.
  • the function which adjusts arbitrarily the position where a Bragg peak is formed in a Z direction by adjustment of particle energy is required.
  • a particle beam generating and transporting apparatus that transports and blocks a particle beam includes an accelerator that accelerates the particle beam, and the accelerator also has an energy adjustment function.
  • a plurality of irradiation positions (also referred to as spots) are set in the tumor, and the particle beam is sequentially irradiated to each irradiation position using the above two mechanisms.
  • the balance of the dose to be applied to each irradiation position is adjusted and determined in advance, and the respective dose distributions applied to the irradiation positions are added together, thereby forming a target distribution as a result.
  • the scanning irradiation method can form an arbitrary dose distribution for the tumor.
  • the target distribution is such that the dose is as uniform as possible inside the tumor and the dose is as low as possible outside the tumor than inside the tumor.
  • the dose necessary for treatment is not irradiated at once, and it is possible to divide it into several to several tens of times and repeat the irradiation for about one week to two months. Many.
  • Japanese Patent No. 5555826 stages 0015, 0035 to 0040, FIG. 3
  • Japanese Patent No. 4936723 (0008-0015)
  • Inaniwa, et al. “Development of treatment planning for scanning irradiation at HIMAC”, Nuclear Instruments and Methods in Physics Research B 266, 2194-2198 (2008)
  • T. Akagi, et al. “The PTSim and TOPAS Projects, Bringing Geant4 to the Particle Therapy Clinic”, Progress in NUCLEAR SCIENCE and TECHNOLOGY, Vol. 2, pp.912-917 (2011)
  • the target distribution may not be the target distribution even though the target distribution should be obtained in the calculation. is there.
  • uncertain factors there are, for example, a time change of the particle beam intensity, a time change and hysteresis of the magnetic field of the scanning electromagnet, a sensitivity variation of the dose monitor, a signal delay and noise of the control device, and the like. These effects may cause the actual dose distribution to differ from the calculated value.
  • Patent Document 1 describes a method and device for performing patient-specific IMRT verification.
  • the IMRT verification method of Patent Document 1 reconstructs the distribution of irradiation photon fluences (number of particles passing through a sphere of unit cross section) corresponding to a beam based on the response of a two-dimensional detector (two-dimensional dose detector). This is a method for calculating a three-dimensional dose distribution on the basis of the reconstructed irradiation photon Ference distribution.
  • Patent Document 2 describes a method and apparatus for calculating a radiation dose distribution of a radiation therapy system using a limited amount of data.
  • a beam quality index representing a radiation beam is determined, and a radiation dose distribution is obtained using a dose deposition kernel parameterized based on the beam quality index.
  • this method it is possible to eliminate static uncertainty in dose calculation due to variations and characteristics of each apparatus, a patient's tumor shape, irradiation field shape, and the like.
  • the present invention does not require a dose detector with a high position resolution, and correctly and quantitatively estimates the effect of both static and dynamic uncertainties on the dose distribution.
  • the purpose is to compensate.
  • the particle beam therapy system of the present invention is a particle beam therapy system that divides a dose necessary for particle beam therapy into a plurality of times and applies it to an irradiation target, and generates particles of energy necessary for particle beam therapy.
  • a beam generator a scanning device that deflects the particle beam in two directions perpendicular to the beam traveling direction, and scans the particle beam at the position where the irradiation target is disposed; a beam transport device that transports the particle beam to the scanning device;
  • a measurement device that measures particle beam information of a particle beam generated by a particle beam generator, an irradiation dose distribution that is given to an irradiation target by the particle beam, and a dose distribution difference that is a difference between the irradiation dose distribution and the target dose distribution
  • a dose distribution calculation device for calculating, a dose distribution calculation device, a beam information storage unit for storing measurement particle beam information measured by the measurement device, and a measurement particle
  • a total dose calculation unit for calculating an irradiation
  • the particle beam therapy system calculates an irradiation dose distribution and a dose distribution difference based on the measured particle beam information, and corrects the dose distribution difference calculated by the treatment planning apparatus in the second and subsequent treatment irradiations. Since it is controlled based on the control data including the beam amount, a dose detector having a high position resolution is not required, and both static and dynamic uncertainties can be compensated.
  • FIG. 1 is a schematic configuration diagram of a particle beam therapy system according to Embodiment 1 of the present invention. It is a figure which shows the structure of the dose distribution calculating apparatus of FIG. It is a figure which shows the hardware constitutions which implement
  • FIG. 1 is a schematic configuration diagram of a particle beam therapy system according to Embodiment 1 of the present invention.
  • FIG. 2 is a diagram showing a configuration of the dose distribution calculation apparatus in FIG. 1
  • FIG. 3 is a diagram showing a hardware configuration for realizing the functional blocks in FIG.
  • FIG. 4 is a diagram showing an example of the data structure input to the dose distribution calculation apparatus of FIG. 1, and
  • FIG. 6 and 7 are diagrams illustrating the flow of particle beam therapy according to the first embodiment of the present invention.
  • a particle beam therapy apparatus 50 that performs particle beam scanning irradiation includes a particle beam generator 1 that generates a particle beam 20 having energy necessary for therapy, and a particle beam irradiation apparatus that includes a scanning device 3.
  • the beam transport device 2 that transports the beam 20 and the particle beam 20 are deflected in two directions perpendicular to the z direction that is the beam traveling direction, that is, the x direction and the y direction, and the particle beam 20 can be scanned at the patient position.
  • a scanning device 3 is provided.
  • the scanning device 3 includes an x-direction scanning electromagnet 4 that deflects the particle beam 20 in the x-direction and a y-direction scanning electromagnet 5 that deflects the particle beam 20 in the y-direction.
  • the particle beam therapy system 50 includes a control unit (not shown) that controls the start and block of the emission of the particle beam 20 by the particle beam generator 1 and the scanning of the particle beam 20 by the scanning device 3, and scanning by the scanning device 3.
  • the dose measuring device 7 that measures the dose value irradiated to each irradiation position of the treatment target (patient) and the particle beam 20 scanned by the x-direction scanning electromagnet 4 and the y-direction scanning electromagnet 5 pass.
  • a position monitor (not shown) for detecting beam information for calculating the passing position (center of gravity position) and size of the beam to be detected.
  • the treatment target (patient) is an irradiation target that irradiates the particle beam 20.
  • the phantom is made under the same conditions as possible in the treatment plan after the particle beam treatment plan is made and before the particle beam 20 is actually irradiated to the patient. It is common to perform beam irradiation on (patient substitute) 21, measure the absolute dose value (absolute dose value) and dose distribution, and check whether it matches the treatment plan. . This operation is called patient QA (Quality Assurance).
  • patient QA Quality Assurance
  • the phantom 21 often uses water in a water tank, and the dose is measured using a dosimetry device installed in the water.
  • the particle beam therapy device 50 when executing the patient QA, as shown in FIG. 1, the phantom 21 is arranged at a position where the patient is fixed during the treatment (particle beam treatment).
  • the particle beam therapy device 50 when executing the patient QA includes a particle beam generator 1, a beam transport device 2, a scanning device 3, a beam energy measuring device 6, a dose measuring device 7, and a beam deflection information measuring device. 8 and a dose distribution calculation device 10.
  • a position monitor (not shown) is disposed between the scanning device 3 and the dose measuring device 7, and the patient is fixed at the position of the phantom 21.
  • the beam energy measuring device 6 measures the energy of particles in the particle beam 20.
  • the beam energy measuring device 6 is, for example, a thin film scintillation detector.
  • the patient QA and the dose measuring device 7 for performing treatment are, for example, ionization chambers, and measure the number of charges of ionized ions (unit charge count value) generated by the particle beam 20.
  • the number of charges of ionized ions has a one-to-one correspondence with the beam amount of the particle beam 20.
  • the beam deflection information measuring device 8 measures the positions x and y of the beam center axis formed by the x-direction scanning electromagnet 4 and the y-direction scanning electromagnet 5. Specifically, the beam deflection information measuring device 8 calculates based on the magnetic field intensity B generated on the path of the particle beam 20 by the scanning device 3, and the beam center axis position x, y that is the position of the beam center axis. Measure.
  • the beam center axis position x is a position in the x direction
  • the beam center axis position y is a position in the y direction.
  • the dose distribution calculation device 10 includes a measurement energy E (t) measured at a plurality of times by the beam energy measurement device 6, for example, at a predetermined time interval ⁇ t, and a measurement charge measured at a plurality of times by the dose measurement device 7. Based on the number Q (t) (measured beam amount) and the measurement beam center axis positions Px (t) and Py (t) measured at a plurality of times by the beam deflection information measuring device 8, the dose distribution is calculated.
  • the energy E, the measurement beam quantity (measurement charge number Q), and the measurement beam center axis positions Px and Py of the particle beam 20 are particle beam information of the particle beam 20.
  • Measurement energy E (t), measurement beam quantity (measurement charge number Q (t)), measurement beam center axis position Px (t), and Py (t) are measurement particle beam information.
  • the dose distribution calculation apparatus 10 includes a database 11 that stores five pieces of information described in the database information 36 of FIG. 6, a measurement charge storage unit 12 that stores the number of measurement charges Q (t), and a measurement beam center axis position Px ( t), a measurement beam central axis storage unit 13 that stores Py (t), a measurement energy storage unit 14 that stores measurement energy E (t), a total dose calculation unit 15, and a planned dose comparison unit 16.
  • the total dose calculation unit 15 and the planned dose comparison unit 16 are realized by the processor 98 executing a program stored in the memory 99. Further, the plurality of processors 98 and the plurality of memories 99 may execute the above functions in cooperation. Details of the dose distribution calculation apparatus 10 will be described later.
  • the total dose given to the tumor volume (tumor region) by scanning irradiation will be described.
  • scanning irradiation a plurality of spots are provided in a tumor volume (tumor region), and each spot is irradiated with an appropriate amount of the particle beam 20, thereby forming a desired total dose distribution 25 as shown in FIG. .
  • the spot number is j
  • the dose evaluation point number in the phantom 21 is i
  • the dose given to the i-th dose evaluation point pi when one particle is irradiated to the j-th spot is d i, j , jth
  • the total dose D i given to the i-th dose evaluation point pi when irradiation of all spots is completed is expressed by the following equation (1).
  • This process is called a treatment plan.
  • the number of particles w j and spot the number of particles w j are referred to as the number of particles w j and spot the number of particles w j.
  • FIG. 5 is an example in which the number and position of spots and the number of spot particles w j are determined in the treatment plan.
  • the vertical axis in FIG. 5 is the dose, and the horizontal axis is the position in the z direction.
  • FIG. 5 shows a one-dimensional example of the spot arrangement and dose distribution in the z-axis (beam traveling direction) direction for simplicity.
  • FIG. 5 shows four spots sp1, sp2, sp3, sp4 and 13 dose evaluation points p1, p2, p3, p4, p5, p6, p7, p8, p9, p10, p11, p12, p13. Indicated.
  • the dose distribution 26 is a dose distribution according to the number of spot particles irradiated to the spot sp1.
  • the dose distributions 27, 28, and 29 are dose distributions depending on the number of spot particles irradiated to the spots sp2, sp3, and sp4, respectively.
  • the total dose distribution 25 is a dose distribution obtained by adding the dose distributions 26, 27, 28, and 29.
  • There are five dose evaluation points outside the tumor which are dose evaluation points p1, p2, and p11 to p13.
  • the total dose distribution 25 can be made high inside the tumor and low outside the tumor by appropriately determining the number of particles w j given to the spots sp1 to sp4.
  • the number of spots is 4 and the dose evaluation points are 13.
  • more spots and dose evaluation points are arranged at short intervals according to the tumor size.
  • the spot arrangement and the dose distribution are displayed only in one dimension in the z-axis direction, but in actuality, the spot is three-dimensionally including the x-axis direction and the y-axis direction in accordance with the tumor shape. Be placed. Since the dose distribution needs to be calculated in three dimensions according to the actual tumor shape, the dose evaluation points are also arranged in three dimensions.
  • the spot positions in the x and y directions that are perpendicular to the beam traveling direction (z direction) are determined by the beam deflection angle, and the beam deflection angle is determined by the magnetic field intensity formed by the scanning device 3. .
  • the spot position in the z-axis direction, which is the beam traveling direction is determined depending on the beam energy of the particle beam 20. Therefore, the particle beam therapy system 50 adjusts the spot position by adjusting the beam energy of the particle beam 20 and the magnetic field strength of the scanning device 3.
  • equation (1) the total dose distribution at the i-th dose evaluation point pi was obtained by adding the dose distribution for each spot.
  • the dose distribution after the irradiation of the particle beam 20 with respect to the same object is completed can also be added for each time, and can be calculated as in equation (2) as in equation (1). It is.
  • Formula (2) is a case where the total irradiation time is divided into m time intervals.
  • k is the number of the time interval.
  • the dose (unit particle dose) given to the i-th dose evaluation point pi is defined as di, k . If the time interval is shortened sufficiently, this equation (2) can reproduce the dose distribution with high accuracy.
  • the time interval is about the same as or shorter than the required time per spot, and for example, about several tens of microseconds to about 1 millisecond is preferable.
  • Same number of particles in a time interval and w k unit grain dose d i, and multiplying the k w k d i, k is the time interval dose.
  • the number of particles w k irradiated in a certain time interval can be measured by, for example, a dose measuring device 7 using an ionization chamber.
  • the ionization chamber is a device that emits an electric signal when the particle beam 20 passes, and between the number of particles of the particle beam 20 that has passed and the number of charges of ionized ions that are emitted (count value of unit charge). Is proportional. Therefore, when the total number of charges generated from the start to the end of a certain time interval is Q k , and the proportionality coefficient between the total number of charges Q k and the number of particles w k of the particle beam 20 is C (E), The number of particles w k can be obtained as in (3).
  • the proportionality coefficient C (E) can be said to be the ratio of the particle number w k to the beam amount.
  • the number of particles w k is referred to as the number of irradiated particles w k as appropriate.
  • E is the energy of the particles in the particle beam 20.
  • the proportionality coefficient has energy dependency, and the proportionality coefficient is an expression including the energy E of particles in the particle beam 20.
  • the proportionality coefficient C (E) needs to be acquired in advance before performing treatment.
  • an acquisition method is proportional coefficient between the total charge number Q kr and particle number w kr is prepared with the known reference ionization chamber, and a therapeutic ionization chamber to be actually used at the time of treatment, the measured value
  • the proportionality coefficient C (E) can be obtained by comparison. Specifically, by arranging a reference ionization chamber downstream of the treatment ionization chamber and irradiating an appropriate amount of the particle beam 20 with a constant energy E, the number of particles w k by the output of the treatment ionization chamber can be obtained .
  • the proportional coefficient C (E) for the energy can be obtained. By performing the same measurement while changing the energy E, it is possible to know the proportionality coefficient C (E) with respect to the arbitrary energy E.
  • the particle energy E in the particle beam 20 can be measured, for example, by using a beam energy measuring device 6 such as a thin film scintillation detector.
  • a beam energy measuring device 6 such as a thin film scintillation detector.
  • the beam energy measuring device 6 when there is a curved portion in the path from the particle beam generating device 1 to the patient or the phantom 21, the beam energy measuring device 6 is arranged in the curved portion of the beam path.
  • a method using a magnetic field of a deflecting electromagnet is conceivable. Specifically, the beam energy can be obtained from the relationship between the magnetic field strength produced by the deflection electromagnet disposed in the curved portion of the beam path and the radius of curvature of the beam path.
  • the dose d i, k can be obtained as follows. It is known that the three-dimensional dose distribution d (x, y, z) can be approximated by the product of the dose distribution in the z direction, the dose distribution in the x direction, and the dose distribution in the y direction. In Inaniwa et al. (Non-Patent Document 1), the three-dimensional dose distribution d (x, y, z) for one beam is expressed in each of the z direction, the x direction, and the y direction as shown in Equation (4). A method for factoring the distribution is introduced.
  • x 0 and y 0 are the coordinates of the central axis of one beam at the depth z.
  • the dose distribution in the z direction does not depend on the coordinates in the x direction and the coordinates in the y direction, but is determined only by the coordinates in the z direction and the beam energy E (beam energy E).
  • the dose distribution in the y-direction varies depending not only on the x-direction coordinate, the y-direction coordinate, and the beam energy E, but also on the z-direction coordinate and the position (x 0 , y 0 ) of the beam center axis.
  • the dose distribution after the irradiation of the particle beam 20 with respect to the same object is completed by adding the dose distribution for each spot as well as adding the dose distribution for each spot.
  • the dose d i, k in the case where is three-dimensional can be expressed as equation (5) by factoring into doses in the z direction, the x direction, and the y direction.
  • d z (z, E) is a dose distribution in the z direction with respect to an arbitrary z coordinate, but is a dose value of the z coordinate with respect to a unique z coordinate.
  • Different dose distributions and doses are used depending on whether they are unique or arbitrary.
  • d x (x, z, E) and d y (y, z, E) For an arbitrary (x, y) coordinate, a dose distribution in the x direction and a dose distribution in the y direction, respectively.
  • a unique (x, y) coordinate is a dose value of the (x, y) coordinate
  • the dose distribution and the dose are selectively used depending on whether the (x, y) coordinate is unique or arbitrary.
  • d z (z, E), d x (x, z, E), dy (y, z, E) are the dose in the z direction, the dose in the x direction, and the dose in the y direction, respectively.
  • D i, d i for even k, selectively used dose distribution and dose depending arbitrary or dose evaluation point unique.
  • the total dose D i and the dose d i, k are expressed, and when used for an arbitrary dose evaluation point, the total dose distribution D i and the dose distribution di , k It expresses.
  • Equation (4) The position of the beam central axis in equation (4) can also be obtained by analytical calculation based on the Lorentz force expressed by equation (6).
  • q, v, and B in equation (6) are the charge of the particle, the velocity of the particle, and the magnetic flux density of the magnetic field applied to the particle, respectively.
  • Formula (6) and Lorentz force demonstrates B as magnetic flux density.
  • the position of the beam central axis may be directly measured and databased in advance. That is, if a position monitor is placed downstream of the scanning device 3 to generate a magnetic field having a certain magnetic field intensity B, the particle beam 20 is irradiated at a certain beam energy E, and the position where the beam central axis has passed is measured.
  • the deflection angle ⁇ of the particle beam 20 can be determined from the arrangement distance between the scanning device 3 and the position monitor. From the deflection angle of the beam, it is possible to calculate an x coordinate and ay coordinate based on the beam center axis at an arbitrary position z (z coordinate). Ideally, the beam deflection angle ⁇ should be measured in advance for all beam energy E and magnetic field strength B that may be used in the treatment.
  • Linear interpolation may be used after such data is acquired.
  • the magnetic field strength B it is expected that there is a linear relationship between the magnetic field strength B and the deflection angle ⁇ from the definition of the Lorentz force. Can be expected.
  • the deflection angle ⁇ in the x direction is expressed as ⁇ x
  • the deflection angle ⁇ in the y direction is expressed as ⁇ y . Since the deflection angle ⁇ depends on the magnetic field strength B and the position z (z coordinate), the deflection angle ⁇ x is appropriately expressed as ⁇ x (B, E), and the deflection angle ⁇ y is set as ⁇ y (B, E).
  • the distribution can be obtained by placing water in a water phantom, placing the dosimeter, and moving the position of the dosimeter in the z direction while irradiating the particle beam 20.
  • the measurement for obtaining the proportionality coefficient C (E) is carried out before carrying out this measurement, the number of irradiated particles w and the treatment ionization chamber at that time are arranged upstream.
  • the dose d in the water phantom can be obtained.
  • grain can be known by calculating
  • Non-patent Document 2 Non-patent Document 2
  • Gantt 4 the dose per particle at an arbitrary position in the water phantom (phantom 21) can be calculated.
  • the shape of the object such as the phantom 21 the energy of the particle beam 20, the generation position and direction of ionization
  • the electromagnet of the scanning device 3 x-direction scanning electromagnet 4, y
  • the dose per particle at an arbitrary position in the water phantom (phantom 21) can be calculated.
  • the dose distribution d x (x ⁇ x 0 , z, E) in the x direction and the dose distribution d x (x, z, E) can be obtained more efficiently than actually measured. it can. dose distribution in the y direction, that is the same for Formula dose distribution in (4) d y (y- y 0, z, E) and the dose distribution d y of formula (5) (y, z, E).
  • the Monte Carlo simulation tool When the Monte Carlo simulation tool is used, not only the dose distribution in the one-dimensional direction but also the three-dimensional dose distribution d (x, y, z) can be directly obtained, and this is calculated in advance and d (x , Y, z) is also possible as a database.
  • d (x , Y, z) is also possible as a database.
  • a large amount of memory capacity is required to store the three-dimensional dose distribution in the storage device. Therefore, the data storage is performed in any form in consideration of the performance of the storage device and the required data accuracy. It is necessary to consider whether to do it.
  • FIG. 6 shows a flowchart of particle beam therapy divided into a plurality of times. First, before starting irradiation (at the time of starting up the facility, etc.), as a preliminary preparation, necessary data is acquired by the method described so far, and the database 11 storing the five pieces of information described in the database information 36 is stored. Work to create (database creation process) is required.
  • the first database is a coefficient for converting the measured charge number Q (t), which is the output charge number of the dose measuring device 7, into the number of particles w, that is, a proportional coefficient C (E).
  • the second database is a dose distribution d z (z, E) in the z direction.
  • the third database is a dose distribution d x (x, z, E) in the x direction.
  • the fourth database is a dose distribution dy (y, z, E) in the y direction.
  • the fifth database includes the magnetic field intensity B formed by the electromagnets (x-direction scanning electromagnet 4 and y-direction scanning electromagnet 5) of the scanning device 3 and the deflection angles ⁇ x (B, E) and ⁇ y (B , E).
  • treatment plan creation step when actually treating a patient, first, CT imaging is performed, and after specifying the position and shape of the tumor, a treatment plan is created by the treatment planning device 22 (treatment plan creation step). Based on the treatment plan, the patient is irradiated with the particle beam 20 (treatment irradiation step).
  • patient QA work patient QA process
  • patient QA is required somewhere in the period from the planning of treatment to the irradiation of the patient.
  • the measurement charge number Q (measurement beam amount) is all data of the measurement charge number Q (t) (information on the measurement beam amount), which is the number of charges of the dose measuring device 7, measured for each time interval ⁇ t.
  • the measurement beam center axis positions Px, Py are measured beam center axis positions Px (t), Py (), which are the magnetic fields of the x direction scanning electromagnet 4 and the y direction scanning electromagnet 5 of the scanning device 3 measured every time interval ⁇ t. t) is all data.
  • the measurement energy E is all data of the measurement energy E (t), which is the beam energy of the particle beam 20, measured every time interval ⁇ t.
  • the measurement charge number Q, measurement beam center axis positions Px, Py, and measurement energy E are stored in the measurement charge storage unit 12, the measurement beam center axis storage unit 13, and the measurement energy storage unit 14, respectively. Since the measurement charge number Q is also called a measurement beam amount, the measurement charge storage unit can also be called a measurement beam amount storage unit.
  • the measurement charge number Q, measurement beam center axis positions Px, Py, and measurement energy E can be summarized as in the data structure of the measurement value storage information 35 described in FIG. At time t1 representing the first measurement interval, the number of measured charges Q (t1), measurement energy E (t1), measurement beam center axis position Px (t1), and Py (t1) are measured.
  • the measured charge number Q (t2), measured energy E (t2), measured beam center axis position Px (t2), and Py (t2) are measured.
  • the number of measured charges Q (t), the measured energy E (t), and the measured beam center axis position Px (t), Py (t) are measured.
  • the measurement charge storage unit 12, the measurement beam central axis storage unit 13, and the measurement energy storage unit 14 may be an external storage area instead of the internal storage area of the dose distribution calculation apparatus 10.
  • the dose distribution calculating unit 10 calculates the total dose distribution D i in the patient (total dose distribution calculation step).
  • total dose distribution calculation step three irradiation particle numbers w k , dose distribution d i, k , and total dose distribution D i described in the calculation result information 38 are calculated.
  • the total dose calculation unit 15 calculates the number of irradiated particles w k from the proportional coefficient C (E) and the measured charge number Q (t) corresponding to the total charge number Q k for each measurement section according to the equation (3).
  • the total dose calculation unit 15 includes the z-direction dose distribution d z (z, E), the x-direction dose distribution d x (x, z, E) selected by the measurement beam center axis positions Px, Py, and the measurement energy E, Based on the y-direction dose distribution d y (y, z, E), the dose distribution d i, k is calculated by Equation (5).
  • the dose distribution calculation device 10 compares the calculated total dose distribution D i with the target dose distribution D obj i per day by the planned dose comparison unit 16, and calculates the dose distribution difference ⁇ D i (7) (Dose distribution difference calculation step).
  • the dose distribution calculation device 10 calculates the dose distribution difference ⁇ D i described in the calculation result information 38. Then, the dose distribution calculation device 10 sends the dose distribution difference ⁇ D i to the treatment planning device 22.
  • Treatment planning system 22 to plan the day following treatment plan to correct for dose distribution difference [Delta] D i (treatment plan correction step). That is, the number of corrected spot particles w c j that satisfies Equation (8) is calculated.
  • the particle beam therapy system 50 performs the irradiation of the particle beam 20 based on the corrected spot particle number w c j .
  • the particle beam therapy system 50 can equalize the irradiation dose distribution (total dose distribution 43) for two days and the target dose distribution for two days. It becomes.
  • the vertical axis in FIG. 8 is the dose, and the horizontal axis is the position in the x direction.
  • the dose distribution 41 is a dose distribution in the x direction by beam irradiation in the treatment on the first day
  • the dose distribution 42 is a dose distribution in the x direction by beam irradiation in the treatment on the second day.
  • the total dose distribution 43 is a dose distribution in the x direction for a total of two days.
  • step S001 the treatment planning device 22 calculates the total number of charges Q j (number of particles w j ) for each spot based on the target dose distribution D obj i per day (treatment plan creation step).
  • step S002 the particle beam therapy system 50 irradiates the patient with the particle beam 20 according to the total number of charges Q j (particle number w j ) for each spot determined in the treatment plan of the treatment plan creation process (first irradiation process). .
  • step S003 the dose distribution calculation unit 10, and the total dose distribution D i, to calculate the dose distribution difference [Delta] D i (dose distribution calculation step).
  • the dose distribution calculation step is a step of executing the above-described total dose distribution calculation step and dose distribution difference calculation step.
  • step S004 the treatment planning device 22 calculates a corrected total charge number Q c j (corrected spot particle number w c j ) for each spot based on the dose distribution difference ⁇ D i (treatment plan correction step).
  • step S005 the particle beam therapy system 50 irradiates the patient with the particle beam 20 according to the corrected total charge number Q c j (corrected spot particle number w c j ) with respect to the spots determined in the treatment planning process (continuation). Irradiation process).
  • steps S003 to S005 are repeated until the number of treatments determined in the treatment plan is reached.
  • the calculation operation of the total dose calculation unit 15 will be described in detail.
  • the total dose calculation unit 15 reads the proportional coefficient C (E) corresponding to the measurement energy E from the database 11 and integrates the measured charge number Q (t) and the proportional coefficient C (E) to obtain the number of irradiated particles w k . Calculate. Further, the calculation of the dose distribution d i, k in the total dose calculation unit 15 will be described by taking the i-th dose evaluation point pi as an example.
  • the total dose calculation unit 15 calculates the dose in the z direction corresponding to the measurement energy E, that is, the selected z direction dose d z , which is the z coordinate of the i th dose evaluation point pi, and the z direction dose distribution d z in the database 11. Derived from (z, E).
  • the total dose calculation unit 15 includes x-direction deflection angles (selected x-direction deflection angles) ⁇ x and y-direction deflection angles (selected y-direction deflection angles) ⁇ corresponding to the measurement beam center axis positions Px and Py and the measurement energy E.
  • y is derived from the beam deflection angles ⁇ x (B, E) and ⁇ y (B, E) in the database 11.
  • Total dose calculation unit 15 calculates the x-coordinate from the x-direction of the deflection angle theta x, the x-coordinate, the x-direction of the dose corresponding to the z-coordinate and measuring the energy E of the dose evaluation point (select x-direction dose) d x Is derived from the x-direction dose distribution d x (x, z, E) in the database 11.
  • the total dose calculation unit 15 calculates the y coordinate from the deflection angle ⁇ y in the y direction, and the y coordinate corresponding to the y coordinate, the z coordinate of the dose evaluation point, and the measurement energy E (selected dose in the y direction).
  • d y is derived from y-direction dose distribution d y database 11 (y, z, E) .
  • Total dose calculation unit 15 the derived z-direction dose d z, x-direction dose d x, based on the dose d y in the y-direction, three dose d z by the equation (5), d x, a d y
  • the total dose calculation unit 15 calculates a dose d i, k for each dose evaluation point and time interval to obtain a dose distribution d i, k .
  • the dose distribution calculation apparatus 10 uses the measurement particle beam information (measurement energy E, measurement beam amount (measurement charge number Q), measurement beam center axis position Px, Py) and the irradiation dose given to the patient.
  • the distribution (total dose distribution D i ) is calculated, the irradiation dose distribution (total dose distribution D i ) is compared with the daily target dose distribution D obj i, and the irradiation dose distribution (total dose distribution D i ) and the target Since the dose distribution difference ⁇ D i , which is the difference from the dose distribution D obj i , is calculated, a dose detector having a high position resolution is not required, and both static and dynamic uncertainties are given to the dose distribution.
  • the impact can be estimated accurately and quantitatively.
  • the corrected total charge number Q c j (corrected spot particle number w calculated by the therapy planning apparatus 22 based on the dose distribution difference ⁇ D i at the time of the second and subsequent treatment irradiations. Since the patient is irradiated with the particle beam 20 according to c j ), a dose detector with high position resolution is not required and both static and dynamic uncertainties can be compensated.
  • the particle beam therapy apparatus 50 when the particle beam therapy apparatus 50 scans the particle beam 20 on the irradiation target by the scanning apparatus 3 and performs the particle beam therapy, the particle beam therapy apparatus 50 gives the irradiation target to the irradiation target.
  • a beam information storage unit for storing measurement particle beam information which is particle beam information of the particle beam 20 measured by the measurement device (beam energy measurement device 6, dose measurement device 7, beam deflection information measurement device 8). 14, measurement beam quantity storage unit (measurement charge storage unit 12), measurement beam center axis storage unit 13), and measurement particle beam information (measurement energy E, measurement beam).
  • Dose distribution calculation unit 10 of the first embodiment this feature based on the measured particle beam information, since the calculation of the radiation dose distribution (total dose distribution D i) and dose distribution difference [Delta] D i, has a high position resolution Without the need for a dose detector, the effects of both static and dynamic uncertainties on dose distribution can be accurately and quantitatively estimated.
  • the particle beam information includes the beam amount, energy, and beam center axis position in the particle beam 20, and the beam information storage unit converts the energy of the particle beam 20 into a plurality of energy.
  • a measurement energy storage unit 14 that stores measurement energy E (t) measured at a time, and beam center axis positions Px (t) and Py (t) measured at a plurality of times of the beam center axis position of the particle beam 20.
  • a measurement beam center axis storage unit 13 for storing the measurement beam amount (measurement charge number Q (t)) obtained by measuring the beam amount of the particle beam 20 at a plurality of times. Part 12).
  • the total dose calculation unit 15 of the dose distribution calculation apparatus 10 uses the measurement energy E (t) and the measurement beam amount (measurement charge number Q (t)) in the same time interval in which the particle beam information is measured. and the number of w k irradiated particles determined based on the measured energy E in the same section of the time interval (t) and the measurement beam center axis position Px (t), were determined on the basis of Py (t), 1 in the particle beam 20
  • the calculation target point (dose evaluation point) of the irradiation target is obtained by adding the time interval dose obtained by integrating the unit particle dose (dose d i, k ) , which is the dose given by each particle, in all time intervals. The dose in pi) is calculated.
  • the planned dose comparison unit 16 of the dose distribution calculation apparatus 10 calculates the dose distribution difference ⁇ D i which is the difference between the irradiation dose distribution (total dose distribution D i ) and the target dose distribution D obj i.
  • the dose distribution calculation apparatus 10 of the first embodiment allows the total dose calculation unit 15 to measure the measurement energy E (t), the measurement beam center axis position Px (t), Py (t), Since the irradiation dose distribution (total dose distribution D i ) and the dose distribution difference ⁇ D i are calculated based on the measured beam amount (measured charge number Q (t)), a dose detector having high position resolution is not required. The effects of both static and dynamic uncertainties on dose distribution can be accurately and quantitatively estimated.
  • the particle beam therapy apparatus 50 is a particle beam therapy apparatus that divides a dose necessary for particle beam therapy into a plurality of times and applies it to an irradiation target.
  • the particle beam 20 has energy necessary for particle beam therapy.
  • a particle beam generator 1 for generating a beam a scanning device 3 for deflecting the particle beam 20 in two directions perpendicular to the traveling direction of the beam, and scanning the particle beam 20 at an irradiation target arrangement position, and scanning the particle beam 20
  • a beam transport device 2 transported to the device 3 and a measurement device (a beam energy measurement device 6, a beam deflection information measurement device 8, a beam amount measurement device) for measuring particle beam information of the particle beam 20 generated by the particle beam generation device 1.
  • Dose measuring device 7 Dose measuring device 7
  • a target dose distribution D obj i and a dose distribution calculation device 10 that calculates a dose distribution difference ⁇ D i , and a dose distribution difference calculated by the treatment planning device 22 in the second and subsequent treatment irradiations Control is performed based on control data including a correction beam amount (corrected total charge number Q c j ) for correcting ⁇ D i .
  • the dose distribution calculation device 10 in the particle beam therapy system 50 stores the measured particle beam information measured by the measurement devices (the beam energy measurement device 6, the dose measurement device 7, and the beam deflection information measurement device 8).
  • Beam information storage unit (measurement energy storage unit 14, measurement beam amount storage unit (measurement charge storage unit 12), measurement beam center axis storage unit 13), measurement particle beam information (measurement energy E, measurement beam amount (number of measurement charges) Q), based on the measurement beam center axis positions Px, Py), a total dose calculation unit 15 that calculates an irradiation dose distribution (total dose distribution D i ), and a planned dose comparison unit 16 that calculates a dose distribution difference ⁇ D i It is characterized by having.
  • the particle beam therapy system 50 uses the measurement particle beam information (measurement energy E, measurement beam amount (measurement charge number Q), measurement beam center axis position Px, Py) as an irradiation dose.
  • the distribution (total dose distribution D i ) and the dose distribution difference ⁇ D i are calculated, and the correction beam amount (corrected total charge) for correcting the dose distribution difference ⁇ D i calculated by the treatment planning device 22 in the second and subsequent treatment irradiations. Because it is controlled based on control data including a number Q c j ), it does not require a dose detector with high position resolution and can compensate for both static and dynamic uncertainties.
  • the treatment plan correction method is a treatment plan correction method for correcting a particle beam treatment plan to be applied to an irradiation target by the particle beam treatment apparatus 50 by dividing a dose necessary for particle beam treatment into a plurality of times.
  • the particle beam information (energy, beam amount, beam center axis position) of the particle beam 20 generated by the particle beam therapy system 50 is measured at a plurality of times to measure particle beam information (measurement energy E, measurement beam amount).
  • the total dose distribution calculation step of calculation for the dose distribution difference calculation step of calculating the dose distribution difference [Delta] D i is the difference between the radiation dose distribution and (total dose distribution D i) between the target dose distribution D obj i, dose distribution difference [Delta] D and a treatment plan correction step of calculating a correction beam amount (corrected total charge number Q c j ) for correcting i .
  • the treatment plan correction method is based on measurement particle beam information (measurement energy E, measurement beam amount (measurement charge number Q), measurement beam center axis position Px, Py), and irradiation dose distribution (total dose distribution D). i ) and the dose distribution difference ⁇ D i are calculated and the dose distribution difference ⁇ D i is sent to the particle beam therapy apparatus 50. Therefore, the dose distribution difference ⁇ D i calculated by the treatment planning apparatus 22 is calculated in the second and subsequent treatment irradiations.
  • the particle beam therapy system 50 is controlled based on the control data including the correction beam amount to be corrected (corrected total charge number Q c j ), so that a dose detector having high position resolution is not required, and static and dynamic Both of the uncertainties can be compensated.
  • the present invention has been described with reference to an example in which the measurement energy E, the measurement beam quantity (measurement charge number Q), and the measurement beam center axis positions Px and Py are simultaneously used as measurement particle beam information measured by the measurement apparatus. There may be only one.
  • the method of calculating the dose distribution of Patent Document 1 requires a two-dimensional dose detector with high accuracy and position resolution of two-dimensional dose detection.
  • the measurement beam amount (measurement charge number Q) is the measurement particle beam information, a dose detector having a high position resolution is not required, and static and dynamic uncertainties are obtained. Both can be compensated.
  • the present invention can be combined with each other, or can be appropriately modified or omitted.
  • SYMBOLS 1 Particle beam generating apparatus, 2 ... Beam transport apparatus, 3 ... Scanning apparatus, 6 ... Beam energy measuring apparatus, 7 ... Dose measuring apparatus, 8 ... Beam deflection information measuring apparatus, 10 ... Dose distribution calculating apparatus, 11 ... Database, DESCRIPTION OF SYMBOLS 12 ... Measurement charge memory
  • E dose evaluation point (calculation target point), E ... measurement energy, E (t) ... measurement energy, Q ... measurement charge number (measurement beam amount), Q (t ) ... Number of measured charges (measurement beam amount), Px, Py ... Measurement beam center axis position, Px (t), Py (t) ... Measurement beam center axis position, C (E) ... Proportional coefficient, di , k ... Dose (unit particle dose) or Dose distribution, w k ... number of particles (number of irradiation particles), D i ... total dose or total dose distribution (irradiation dose distribution), ⁇ D i ... dose distribution difference, D obj i ... target dose distribution, Q c j ...

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Abstract

La présente invention concerne un appareil de thérapie par faisceau de particules (50) qui est pourvu d'un appareil de calcul de distribution de dose (10) qui comprend : une unité de stockage d'informations de faisceau (une unité de stockage d'énergie mesurée (14), une unité de stockage de charge mesurée (12), et une unité de stockage d'axe central de faisceau mesurée (13)) qui stocke des informations de faisceau de particules mesurées qui sont des informations de faisceau de particules d'un faisceau de particules (20) mesurées par des appareils de mesure (6, 7, 8) ; une unité de calcul de dose totale (15) qui calcule la distribution de dose de rayonnement (distribution de dose totale (Di)) sur la base des informations de faisceau de particules mesurées (énergie mesurée (E), dose de faisceau mesurée (nombre de charges mesuré (Q)), et position d'axe central de faisceau mesurée (Px, Py)) ; et une unité de comparaison de dose planifiée (16) qui calcule une différence de distribution de dose (ΔDi) qui est la différence entre la distribution de dose de rayonnement (distribution de dose totale (Di)) et une distribution de dose cible (Dobj i). À partir du second rayonnement thérapeutique, l'appareil de thérapie par faisceau de particules (50) est commandé sur la base des données de commande qui comprennent une dose de faisceau corrigée (nombre de charge totale corrigée (Qc j)) qui corrige la différence de distribution de dose (ΔDi).
PCT/JP2015/081731 2015-11-11 2015-11-11 Appareil de thérapie par faisceau de particules et procédé de correction de plan de traitement WO2017081768A1 (fr)

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