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Abstract(s)
A radioterapia é uma principais armas de combate (não cirúrgica) no tratamento oncológico. Cerca de 40% dos doentes oncológicos recebem tratamento radioterapêutico, de forma isolada ou complementar com outras modalidades terapêuticas, no decorrer do tratamento. A interrupção de um tratamento radioterapêutico de forma não programada é invariavelmente prejudicial à conclusão com sucesso do mesmo. O esquema de compensação de tratamento é exclusivamente elaborado para cada caso, podendo resultar na conclusão do tratamento de acordo com o inicialmente prescrito pelo médico, ou em alterações no número de frações de tratamento e ou na dose por fração. O aumento continuo de casos de interrupções gerou a necessidade de atualizar e agilizar o processo de calculo de compensações de tratamentos interrompidos, que até à data era feito de forma manual. Neste trabalho foi desenvolvida, em Matlab, uma aplicação que, utilizando os conceitos radiobiológicos de Dose Biológica Efetiva (BED) e Equivalente Dose (EQD2) baseados no modelo radiobiológico linear quadrático, permite automatizar a determinação de esquemas de compensação para tratamentos de radioterapia que tenham sofrido interrupções. A comparação da aplicação criada, com outras, no que toca às funcionalidades essenciais ao cálculo de compensação de dose – BED e EQD2 para tecido tumoral e órgãos de risco (OARs); rácios a/b; várias soluções para esquemas de compensação, sugestões automáticas de esquemas de compensação – permitiu avaliar a sua adequação e mostrar que a aplicação é completa e pode ser utilizada em prática clínica. A elaboração de esquemas de compensação, com recurso à aplicação desenvolvida, para os 14 casos escolhidos de forma aleatória, de tratamentos previamente interrompidos na clínica Júlio Teixeira S.A., possibilitou a comparação dos esquemas gerados pela aplicação com os esquemas escolhidos pelo corpo clínico. Comprovou-se com os resultados obtidos a fiabilidade e versatilidade da aplicação desenvolvida, uma vez que a resposta clínica seguiu na maioria dos casos a mesma linha de pensamento que as sugestões geradas pela aplicação de forma automática. A implementação da aplicação na clínica refletiu a agilização do processo de calculo de compensação de tratamentos interrompidos.
Radiotherapy is one of the main weapons (non-surgical) used in cancer treatment. Nearly 40% of oncological patients receive radiotherapeutic treatment, alone or in addition to other therapeutic modalities, during the course of the treatment. The interruption of an unscheduled radiotherapeutic treatment is invariably detrimental to its successful completion. The treatment compensation scheme is designed for each case and may result in the completion of treatment as initially prescribed by the clinician, or in changes in the number of treatment fractions and/or the dose per fraction. The continuous increase on the number of cases with interruptions has created the need to update and speed up the calculating process of compensation for interrupted treatments, which until now was being done manually. In this project, a Matlab software was developed to allow an automatic analysis of compensation schemes for interrupted treatments, using the radiobiological concepts of Biologically Effective Dose (BED) and Equivalent Dose (EQD2) based on de Linear Quadratic Model. By comparing the software crated, with others, regarding the essential features of dose compensation calculations – BED and EQD2 for tumor tissue and organs at risk (OARs); a/b ratios; various solutions for compensation schemes; automatic suggestions for compensation schemes – proved the software is complete and suitable for clinical practice. The elaboration of compensation schemes, using the developed software, for the 14 cases randomly chosen, of previously interrupted treatments at the Júlio Teixeira S.A., made it possible to compare generated schemes by the software with the compensation schemes chosen by the clinical staff. Therefore, the reliability and versatility of the developed software was proven with the results obtained, since clinical response followed in most cases the same line of thought as the suggestions automatically generated by the developed software. The implementation of the software in clinical practice, reflected the goal of this project in creating a tool that would streamline the process of calculating compensations for treatment gaps.
Radiotherapy is one of the main weapons (non-surgical) used in cancer treatment. Nearly 40% of oncological patients receive radiotherapeutic treatment, alone or in addition to other therapeutic modalities, during the course of the treatment. The interruption of an unscheduled radiotherapeutic treatment is invariably detrimental to its successful completion. The treatment compensation scheme is designed for each case and may result in the completion of treatment as initially prescribed by the clinician, or in changes in the number of treatment fractions and/or the dose per fraction. The continuous increase on the number of cases with interruptions has created the need to update and speed up the calculating process of compensation for interrupted treatments, which until now was being done manually. In this project, a Matlab software was developed to allow an automatic analysis of compensation schemes for interrupted treatments, using the radiobiological concepts of Biologically Effective Dose (BED) and Equivalent Dose (EQD2) based on de Linear Quadratic Model. By comparing the software crated, with others, regarding the essential features of dose compensation calculations – BED and EQD2 for tumor tissue and organs at risk (OARs); a/b ratios; various solutions for compensation schemes; automatic suggestions for compensation schemes – proved the software is complete and suitable for clinical practice. The elaboration of compensation schemes, using the developed software, for the 14 cases randomly chosen, of previously interrupted treatments at the Júlio Teixeira S.A., made it possible to compare generated schemes by the software with the compensation schemes chosen by the clinical staff. Therefore, the reliability and versatility of the developed software was proven with the results obtained, since clinical response followed in most cases the same line of thought as the suggestions automatically generated by the developed software. The implementation of the software in clinical practice, reflected the goal of this project in creating a tool that would streamline the process of calculating compensations for treatment gaps.
Description
Keywords
Radioterapia Interrupções Compensação de tratamento Modelo linear quadrático Dose biológica efetiva Radiotherapy Interruptions Treatment compensation Linear quadratic model Biologically effective dose