华北地区IGRT技术临床应用状况调查分析

目的 中国医学物理分会京津冀鲁晋豫地区放射物理专业组为了解华北地区IGRT应用状况进行了调查。方法 2014年12月25日至2015年4月25日采用普查方式,通过电话和电子邮件发送表格的方法。结果 华北地区共有放疗单位507家,已有64家引进了IGRT设备,60家已开展应用。(1)人员:共3 407名,其中放射肿瘤科医师1101名(副高以上372名),物理师325名(副高以上42名),技师801名(副高以上23名),维修工程技术人员63名(副高以上15名),护士1 117名(副高以上55名)。(2)设备:治疗机共163台,其中图像引导治疗机91台。(3) IGRT应用情况:不同单位采用IGRT的比例差异较大,IGRT的应用策略也不尽相同。(4) QA:主要包括空间分辨率、密度分辨率、均匀度、空间变形、图像中心与治疗中心一致性、信噪比,检测频率以月检为主。(5) IGRT经验:开展图像引导有助于减小摆位误差,提高治疗精度,但延长了治疗时间,增加了患者的受量,需要针对性制定并实施适合的IGRT流程及应用策略。结论 我国放疗机普及水平与世界还有较大差距,目前IGRT工作开展情况差别较大,需要制定统一的应用规范以保证IGRT工作顺利开展和质量。

A survey of clinical application of image-guided radiotherapy in North China

Objective To conduct a survey to investigate the current status of clinical application of image-guided radiotherapy (IGRT) in North China.Methods A census was performed by telephone and email from December 25,2014 to April 25,2015.Results In a total of 507 radiation oncology centers in North China,64 had already purchased IGRT equipment,and 60 had already applied IGRT.A total of 3407 staff members were involved in the application of IGRT,consisting of 1101 doctors (372 associate or full professors),325 physicists (42 associate or full professors),801 technicians (23 associate or full professors),63 engineers (15 associate or full professors),and 1117 nurses (55 associate or full professors).There were 163 devices,91 of which were available for IGRT.The frequency and strategy in the application of IGRT varied among centers.The main components of quality assurance (QA) included spatial resolution,density resolution,uniformity,spatial distortion,consistency between imaging center and treatment center,and signal-to-noise ratio.The inspection was performed monthly.IGRT helped to reduce positioning error and improve treatment accuracy.However,it prolonged treatment duration and increased patient's exposure to radiation.The design and implementation of appropriate IGRT protocol and strategy need to be individualized.Conclusions The popularization of radiation treatment units in China is far below the world level.The current application of IGRT varies a lot among different centers.Standardized procedures need to be made to ensure the robust application and quality of IGRT.