RESUMO
BACKGROUND: Isocenter deviation, often induced by small displacements of both the device and the patient, is a common error seen in radiotherapy. In this study, we investigated the impact of isocenter deviation on the results of the volumetric modulated arc therapy (VMAT) plan and dosimetric verification gamma passing rate in the treatment of cervical cancer. METHODS: The clinical data of 15 patients with cervical cancer who were treated with VMAT were retrospectively collected and analyzed. In this study, the isocenter site modification method was adopted. The VMAT plan with isocenter deviation adjustment was set as the experimental group, while the original plan was set as the control group. The impact of isocenter deviation on the results of the VMAT plan and dosimetric verification gamma passing rate was analyzed. Applying gamma analysis with different test criterions, the impact of isocenter deviation on the gamma passing rates was evaluated, and the sensitivity of different test criterions in identifying isocenter deviation was also analyzed. RESULTS: There was a significant difference in the average dose in the target area between experimental group and control group (P<0.05). In organs at risk (OAR) terms, isocenter deviations also caused significant differences in dose parameters between the two groups. Except that there was no significant difference in the rectal V40 between two groups when the isocenter deviation was greater than 3 mm in the y axis direction. With the increase in the isocenter deviation, there was a trend towards decreased gamma passing rates with different analysis criterions in the experimental group. The 2 mm/2% standard had the highest sensitivity for identifying isocenter deviation. CONCLUSIONS: Isocenter deviation has significant effects on the results of the volume rotation intensity modulation plan and dosimetric verification gamma passing rates in the treatment of cervical cancer. When the isocenter deviation was less than 3 mm, a higher gamma passing rate (>90%) could also be obtained under the condition of the 3 mm/3% test criterions. It is recommended that the 2 mm/2% test standard should be utilized in clinical practice.
RESUMO
Four controversial types of simplex reinforcing-reducing manipulation of acupuncture and their possible meanings were summarized to explore several key elements of reinforcing-reducing manipulation of acupuncture, in addition, the simplex reinforcing-reducing manipulation of acupuncture was classified by single factor. It is concluded that the definition of simplex reinforcing-reducing manipulation of acupuncture should try not to include other non-manipulative elements. According to single factor, it can be divided into: needle-oriented reinforcing-reducing manipulation, twisting reinforcing-reducing manipulation, lifting and interpolating reinforcing-reducing manipulation, fast and slow reinforcing-reducing manipulation, breathing reinforcing-reducing manipulation, opening and closing reinforcing-reducing manipulation. In addition, after considering the effect and principle of number reinforcing-reducing manipulation, it can be considered.
