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Quantifying clinical severity of physics errors in high-dose rate prostate brachytherapy using simulations.
Nunez, David Aramburu; Trager, Michael; Beaudry, Joel; Cohen, Gilad N; Dauer, Lawrence T; Gorovets, Daniel; Hassan Rezaeian, Nima; Kollmeier, Marisa A; Leong, Brian; McCann, Patrick; Williamson, Matthew; Zelefsky, Michael J; Damato, Antonio L.
Afiliación
  • Nunez DA; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Trager M; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Beaudry J; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Cohen GN; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Dauer LT; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Gorovets D; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Hassan Rezaeian N; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Kollmeier MA; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Leong B; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • McCann P; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Williamson M; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Zelefsky MJ; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Damato AL; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: damatoa@mskcc.org.
Brachytherapy ; 20(5): 1062-1069, 2021.
Article en En | MEDLINE | ID: mdl-34193362
PURPOSE: To quantitatively evaluate through automated simulations the clinical significance of potential high-dose rate (HDR) prostate brachytherapy (HDRPB) physics errors selected from our internal failure-modes and effect analysis (FMEA). METHODS AND MATERIALS: A list of failure modes was compiled and scored independently by 8 brachytherapy physicists on a one-to-ten scale for severity (S), occurrence (O), and detectability (D), with risk priority number (RPN) = SxOxD. Variability of RPNs across observers (standard deviation/average) was calculated. Six idealized HDRPB plans were generated, and error simulations were performed: single (N = 1722) and systematic (N = 126) catheter shifts (craniocaudal; -1cm:1 cm); single catheter digitization errors (tip and connector needle-tips displaced independently in random directions; 0.1 cm:0.5 cm; N = 44,318); and swaps (two catheters swapped during digitization or connection; N = 528). The deviations due to each error in prostate D90%, urethra D20%, and rectum D1cm3 were analyzed using two thresholds: 5-20% (possible clinical impact) and >20% (potentially reportable events). RESULTS: Twenty-nine relevant failure modes were described. Overall, RPNs ranged from 6 to 108 (average ± 1 standard deviation, 46 ± 23), with responder variability ranging from 19% to 184% (average 75% ± 30%). Potentially reportable events were observed in the simulations for systematic shifts >0.4 cm for prostate and digitization errors >0.3 cm for the urethra and >0.4 cm for rectum. Possible clinical impact was observed for catheter swaps (all organs), systematic shifts >0.2 cm for prostate and >0.4 cm for rectum, and digitization errors >0.2 cm for prostate and >0.1 cm for urethra and rectum. CONCLUSIONS: A high variability in RPN scores was observed. Systematic simulations can provide insight in the severity scoring of multiple failure modes, supplementing typical FMEA approaches.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Braquiterapia Límite: Humans / Male Idioma: En Revista: Brachytherapy Asunto de la revista: RADIOTERAPIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Braquiterapia Límite: Humans / Male Idioma: En Revista: Brachytherapy Asunto de la revista: RADIOTERAPIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos