動体追跡陽子線治療における照射ログファイルを用いた実績線量評価に関する研究

Berbeco, R. I., Nishioka, S., Shirato, H., Chen, G. T., Jiang, S. B. (2005). Residual motion of

lung tumours in gated radiotherapy with external respiratory surrogates. Phys. Med. Biol. 50,

3655–3667.

Bert, C., Grozinger, S. O. and Rietzel, E. (2008). Quantification of interplay effects of scanned

particle beams and moving targets. Phys. Med. Biol. 53, 2253–2265.

Bert, C., Gemmel, A., Saito, N. and Rietzel, E. (2009). Gated irradiation with scanned particle

beams. Int. J. Radiat. Oncol. Biol. Phys., 73, 1270–1275.

Colvill, E., Petersen, J. B. B., Hansen, R., Worm, E., Skouboe, S., Høyer, M. and Poulsen, P.

R. (2018). Validation of fast motion-including dose reconstruction for proton scanning therapy

in the liver. Phys. Med. Biol. 63, 225021.

Fujii, Y., Matsuura, T., Takao, S., Matsuzaki, Y., Fujii, T., Miyamoto, N., Umegaki, K., Nishioka,

K., Shimizu, S. and Shirato, H. (2017). A simulation study on the dosimetric benefit of realtime motion compensation in spot-scanning proton therapy for prostate. J. Radiat. Res. 1-7.

Furukawa, T., Inaniwa, T., Hara, Y., Mizushima, K., Shirai, T., and Noda, K. (2013). Patientspecific QA and delivery verification of scanned ion beam at NIRS-HIMAC. Med. Phys. 40,

121707.

Grozinger, S. O., Bert, C., Haberer, T., Kraft, G. and Rietzel, E. (2008). Motion compensation

with a scanned ion beam: a technical feasibility study. Radiat. Oncol. 3, 34.

Hoogeman, M., Prevost, J. B., Nuyttens, J., Poll, J., Levendag, P. and Heijmen, B. (2009).

Clinical accuracy of the respiratory tumortracking system of the cyberknife: assessment by

analysis of log files. Int. J. Radiat. Oncol. Biol. Phys. 74, 297–303.

Jang, S., Huh, G., Park, S., Yang, P. and Cho, E. (2014). The impact of respiratory gating on

lung dosimetry in stereotactic body radiotherapy for lung cancer. Phys. Med. 30, 682-689.

Jia, B., Ouyang, L., Zhao, Z. (2018). Simulation of an Octupole Scanning Magnet for Spot

Scanning in Proton Therapy. IEEE Trans. Apple. Supercond. 28, 4400304.

44

Johnson, J. E., Beltran, C., Tseung, H. W. C., Mundy, D. W., Kruse, J. J., Whitaker, T. J.,

Herman, M. G. and Furutani, K. M. (2019). Highly efficient and sensitive patient-specific

quality assurance for spot-scanned proton therapy. PLOS ONE. 14, e0212412.

Kamino, Y., Takayama, K., Kokubo, M., Narita, Y., Hirai, E., Kawawda, N., Mizowaki, T.,

Nagata, Y., Nishidai, T. and Hiraoka, M. (2006). Development of a four-dimensional imageguided radiotherapy system with a gimbaled x-ray head. Int. J. Radiat. Oncol. Biol. Phys. 66,

271–278.

Kamerling, C. P., Fast, M. F., Ziegenhein, P., Menten, M. J., Nill, S. and Oelfke, U. (2017).

Online dose reconstruction for tracked volumetric arc therapy: Real-time implementation and

offline quality assurance for prostate SBRT. Med. Phys. 44, 5997-6007.

Knopf, A. C., Hong, T. S. and Lomax, A. (2011). Scanned proton radiotherapy for mobile

targets-the effectiveness of re-scanning in the context of different treatment planning

approaches and for different motion characteristics. Phys. Med. Biol., 56, 7257–7271.

Li, H., Sahoo, N., Poenisch, F., Suzuki, K., Li, Y., Li, X., Zhang, X., Lee, A. K., Gillin, M. T. and

Zhu, X. R. (2013). Use of treatment log files in spot scanning proton therapy as part of patientspecific quality assurance. Med. Phys. 40, 021703.

Low, D. A., Harms, W. B., Mutic, S. and Purdy, J. A. (1998). A technique for the quantitative

evaluation of dose distributions, Med. Phys. 25, 656-661.

Matsuura, T., Fujii, Y., Takao, S., Yamada, T., Matsuzaki, Y., Miyamoto, N., Takayanagi, T.,

Fujitaka, S., Shimizu, S., Shirato, H., et al. (2016). Development and evaluation of a shortrange applicator for treating superficial moving tumors with respiratory-gated spot-scanning

proton therapy using real-time image guidance. Phys. Med. Biol. 61, 1515-1531.

Matsuura, T., Hirayama, S., Koyano, H., Takao, S., Fujii, T., Yamada, T., Fujii, Y., Nihongi, H.,

Shimizu, S., Umegaki, K. et al. (2017). Development of a system for evaluating the actual

dose distribution in respiratory-gated spot-scanning proton therapy using real-time image

guidance. Med. Phys. 44, 2992.

Meier, G., Besson, R., Nanz, A., Safai, S. and Lomax, A. J. (2015). Independent dose

calculations for commissioning, quality assurance and dose reconstruction of PBS proton

therapy. Phys. Med. Biol. 60, 2819–2836.

45

Minohara, S., Kanai, T., Endo, M., Noda, K. and Kanazawa, M. (2000). Respiratory gated

irradiation system for heavy-ion radiotherapy. Int J Radiat Oncol Biol Phys, 47:1097–1103.

Paganetti, H. (2012). Range uncertainties in proton therapy and the role of Monte Carlo

simulations. Phys. Med. Biol. 57, R99-R117.

Scandurra, D., Albertini, F., van der Meer, R., Meier, G., Weber, D. C., Bolsi, A. and Lomax,

A. (2016). Assessing the quality of proton PBS treatment delivery using machine log files:

comprehensive analysis of clinical treatments delivered at PSI Gantry 2. Phys. Med. Biol. 61,

1171–1181.

Schreibmann, E., Dhabaan, A., Elder, E. and Fox, T. (2009). Patient-specific quality

assurance method for VMAT treatment delivery. Med. Phys. 36, 4530-4535.

Shimizu, S., Miyamoto, N., Matsuura, T., Fujii, Y., Umezawa, M., Umegaki, K., Hiramoto, K.

and Shirato, H. (2014a). A Proton beam therapy system dedicated to spot-scanning increases

accuracy with moving tumors by real-time imaging and gating reduces equipment size. PLOS

ONE. 9, e94971.

Shimizu, S., Matsuura, T., Umezawa, M., Hiramoto, K., Miyamoto, N., Umegaki, K. and

Shirato, H. (2014b). Preliminary analysis for integration of spot-scanning proton beam

therapy and real-time imaging and gating. Phys. Med. 30, 555-558.

Shirato, H., Shimizu, S., Shimizu, T., Nishioka, T. and Miyasaka, K. (1999). Real-time tumourtracking radiotherapy. Lancet. 353, 1331-1332.

Takayanagi, T., Hirayama, S., Fujitaka, S. and Fujimoto, R. (2017), A simplified Monte Carlo

algorithm considering large‐angle scattering for fast and accurate calculation of proton dose.

J. Appl. Clin. Med. Phys. 19, 60–72.

Teke, T., Bergman, A. M., Kwa, W., Gill, B., Duzenli, C. and Popescu, I. A. (2010). Monte

Carlo based, patient-specific RapidArc QA using Linac log files. Med. Phys. 37, 116-123.

Tsunashima, Y., Vedam, S., Dong, L., Umezawa, M., Balter, P. and Mohan, R. (2010). The

precision of respiratory-gated delivery of synchrotron-based pulsed beam proton therapy.

Phys. Med. Biol. 55, 7638-7647.

Wagman, R., Yorke, E., Ford, E., Giraud, P., Mageras, G., Minsky, B. and Rosenzweig, K.

46

(2003). Respiratory gating for liver tumors: use in dose escalation. Int. J. Radiat. Oncol. Biol.

Phys. 55, 659–668.

Yamada, T., Miyamoto, N., Matsuura, T., Takao, S., Fujii, Y., Matsuzaki, Y., Koyano, H.,

Umezawa, M., Nihongi, H., Shimizu, S., et al., (2016). Optimization and evaluation of multiple

gating beam delivery in a synchrotron-based proton beam scanning system using a real-time

imaging technique. J. Appl. Clin. Med. Phys., 32, 932-937.

Yamada, T., Nagashima, K., Nomura, T., Soeda, S., Hino, N. (2022). Concept of scanning

magnet with distributed winding coils for particle beam therapy. Phys. Rev. Accel. Beams, 25,

122402.

Zhu, X. R., Poenisch, F., Song, X., Johnson, J. L., Ciangaru, G., Taylor, M. B., Lii, M., Martin,

C., Arjomandy, B., Lee, A. K., et al., (2011). Patient-specific quality assurance for prostate

cancer patients receiving spot scanning proton therapy using single-field uniform dose. Int. J.

Radiat. Oncol. Biol. Phys. 81, 552-559.

Zhu, X. R., Li, Y., Mackin, D., Li, H., Poenisch, F., Lee, A. K., Mahajan, A., Frank, S. J., Gillin,

M. T., Sahoo, N., et al., (2015). Towards effective and efficient patient-specific quality

assurance for spot scanning proton therapy. Cancers. 7, 631-647.

47

目次

発表論文目録および学会発表目録 ........................................................................................ 1

緒言 ...................................................................................................................................... 3

陽子線治療の特徴 ............................................................................................................. 3

陽子線の照射方法 ............................................................................................................. 3

シンクロトロンを用いた陽子線の生成 ............................................................................. 6

スポットスキャニング照射の誤差要因 ............................................................................. 8

呼吸性移動の対応方法 ...................................................................................................... 9

動体追跡陽子線治療 .......................................................................................................... 9

陽子線治療におけるログデータの活用 ............................................................................10

本研究の目的 ...................................................................................................................10

略語表 ..................................................................................................................................12

第一章 肝臓がん動体追跡陽子線治療おけるログデータを用いた実績線量評価 ...............13

1.1 緒言 ............................................................................................................................13

1.2 方法 ............................................................................................................................13

実績線量分布の再構成方法 ..............................................................................................13

ログデータの取得方法 .....................................................................................................14

ログデータの関連付けおよび同期方法 ............................................................................16

実績スポットファイルの作成方法 ...................................................................................16

実績線量分布の検証方法..................................................................................................18

実績線量分布の評価条件..................................................................................................19

1.3 結果 ............................................................................................................................21

実績線量分布の検証 .........................................................................................................21

実績線量分布の評価 .........................................................................................................22

1.4 考察 ............................................................................................................................25

第二章 ログデータを用いた患者 QA の省力化 ..................................................................29

2.1 緒言 ............................................................................................................................29

北海道大学における陽子線治療向け患者 QA...................................................................29

2.2 方法 ............................................................................................................................30

ログベースの線量計算による患者 QA 省力化 ..................................................................30

Simplified Monte Carlo Method ........................................................................................31

精度評価方法 ...................................................................................................................31

2.3 結果 ............................................................................................................................36

線量分布形状の検証：立方体照射 ...................................................................................36

線量分布形状の検証：患者治療計画 ................................................................................36

絶対線量精度の検証 .........................................................................................................37

2.4 考察 ............................................................................................................................39

48

総括および結論 ...................................................................................................................41

謝辞 .....................................................................................................................................43

引用文献 ..............................................................................................................................44

49

...