Background technology
Cancer is the huge dead shade that shrouds this century on human tau, and it is the same with AIDS to become the most difficult demon who captures who threatens whole human survival.According to World Health Organization (WHO) statistics, global cancer new cases are 9,000,000/year, in 5,000,000 people/years of death toll, will there be 300,000,000 new cases and 200,000,000 people's death in from now on 25 years.China seventies, annual new cases are below 1,000,000, and are dead more than 70 ten thousand, and to the nineties, annual new cases increase severely 60%, reach 1,600,000 people, dead 1,300,000 people.In the face of these startling numerals, national governments, medical circle, business circles all up-to-date technological achievement, state-of-the-art armarium, are put into and are captured in cancer campaign and the new product development.People are fully aware of, and who has captured cancer earlier, and who has just not only solved the significant medical difficult problem in the human survival health, and at first captured the commanding elevation in science and technology and the commercial competition.Tackle cancer, one of generally acknowledged the most effective treatment means is a radiotherapy, and it develops in disease controlling, eradicates the attacking in the point war of tumor, has conclusive effect, and statistics shows that the cancer patient who has on 60% need accept radiotherapy.The phase I of theratron development is the beginning of the fifties, and a kind of cobalt-60 theratron perpendicular to the focus irradiation comes out, and is engaged in the radiation oncology treatment for medical circle and lays a good foundation.The second stage of theratron development is the mid-80, the cobalt of vertical irradiation-60 radiotherapy machine develops into irradiation head can just change 180 ° or the negative rotary-type radiotherapy unit that changes 180 ° in a plane, new equipment has improved the motility of ray projection, can implement treatment to focus from different sides and angle, and progressively form radiotherapy four principle theoretical systems.This theoretical system is a basic point with minimum normal tissue injury and maximum tumor radiotherapy dosage, and unremitting effort has been carried out in countries in the world for this reason.That comes out one after another has: dissimilar products such as vertical type cobalt-60 theratron, rotary cobalt-60 theratron, rotary linear accelerator, head cobalt-60 gamma knife, whole body cobalt-60 gamma knife, X linear accelerator knife system.But all there are various dissimilar problems in these devices, can not satisfy the requirement of radiotherapy four principles, and it is very inconvenient to use, and its application is greatly limited.The phase III of theratron development, start from the formation of the mid-90 conformal modulating radiotherapy notion and the invention of vane type multi-leaf collimator technology.The shape that can realize roentgenization in therapeutic process is consistent with the shape of tumor target area, its objective is to make a ray kill cancer cell, the good tissue of few damage.At the multi-leaf collimator device that is installed at the radiotherapy chain-drive section of usefulness, be exactly that its typical case uses at present.Also have various X-knife systems, the knife, equipment of same item derivation type all to belong to this in addition.The greatest problem that these cuttves exist is, roentgenization after the accumulation has improved the target area therapeutic dose, and the subclinical focal zone outside the target area also need shine with second filial generation conventional radiotheraphy equipment restock, and the complicated expense of process is also high, be not that very good commercialization radiation is provided with, it is very big to use limitation.The quadravalence section of theratron development is the end of the nineties, and Mackie has proposed the radiotherapy of Tomotherapy tomography and added conformal intensity modulated notion, and a kind of advanced more radiotherapy apparatus that medical physics system of Univ Wisconsin-Madison USA is developing is exactly its application.It is that design has a kind of linear accelerator band multi-leaf collimator collimator irradiation head, can realize 360 ° the radiocurable device of helical scanning around patient.Compared with present domestic and international third generation radiotherapy apparatus in usefulness, this device is because it has used suitable shape and tomoscan radiotherapy technology, thereby more effectively increase the radiation dose of kill cancer cell tissue, simultaneously further reduced the damage that the radiotherapy process is brought to normal structure again, bigger superiority has been arranged.But its shortcoming still need be shone with second filial generation conventional radiotheraphy equipment restock.Conformal therapy needs accurately to determine the shape and the position of tumor, though accurately suitable shape radiation helps improving the radiation dose of oncotherapy, and the wriggling of patient's intracorporeal organ and breathing all can cause the change of tumor shape and position.Though tomoscan radiotherapy can further reduce normal tissue injury, can not the kill tumor border and the border beyond cancer cell tissue, therefore, simple to rely on suitable shape tomography radiotherapy be far from being enough.The tomoscan multi-leaf collimator radiotheraphy device that medical physics system of Univ Wisconsin-Madison USA is designing, owing to have only a radioactive source generator, when carrying out tomography radiotherapy, spiral irradiation around human body can only form single radiator plane, it is still bigger to be in the dosage that the normal structure of position of fault is subjected to, be subjected to the restriction of normal tissue injury, and then have influence on the tumor irradiation time and cause exposure dose not enough, tumor tissues can not be caused death.Do not have and to carry out big wild irradiation modulation function simultaneously, and need the restock irradiation.Big technical barrier of clinical radiation oncology circle of another long-term puzzlement is how to solve patient's relocating and the dosage validation problem after moving.Therefore, press for a kind of treatment plan design-simulation location-pendulum position reconstruction-intensity modulated radiation therapy-dosage monitoring-prescription that can collect and be revised as one, and the radiotherapy apparatus of once promptly finishing the treatment overall process that the patient need not to move.
Summary of the invention
The objective of the invention is to: provide a kind of and can collect treatment plan design, simulation location, a pendulum position reconstruction, intensity modulated radiation therapy, dosage monitoring, prescription and be revised as incorporate cobalt-60 multi-lamination non-coplanar spiral lamination strength adjustable radiotherapy system equipment.
The objective of the invention is to realize by the enforcement following technical proposals:
Cobalt-60 multi-lamination non-coplanar spiral lamination strength adjustable radiotherapy system is made of four major parts such as treatment main frame, spiral three-dimensional therapeutic bed, central control board and radiotherapy treatment planning systems.The treatment main frame by be installed on the base main support, two ends are made up of the rotary body and the rotary drive mechanism thereof of bearing fixing; Rotary body is a multi-layer sleeve structure, be equipped with on its structure sheaf a plurality of non-coplanes, etc. the radioactive source shielding pig of central beam, device has heavy dose of cobalt-60 radioactive source of high specific activity 150--400 Curie/gram in the shielding pig, centre-to-centre spacing such as source are SAD=1050mm, its total loading of source amount capacity is 18000 Curie, and the center precision such as source beam of treatment main frame are up to ± 0.1mm.Control the hydropneumatic that radioactive source opens and close in addition and penetrate the source drawer device, with can carry out the synthetic cylindric and multi-leaf collimator collimator system assembly of radiation field size, the multi-leaf collimator collimator, its range of exposures is adjustable continuously from 40 * 40mm--360 * 360mm, and cylindric collimator has 14 kinds of series, its range of exposures by these two kinds of collimators, can be arbitrarily made with several thousand kinds of compound illumination scheme from 3mm-- 40mm.The design that it is original, created a cover make conformal intensity modulated, open the brand-new theoretical method that wild compound irradiation and suitable shape avoid up-to-date radiation therapy technology such as radiotherapy to combine together.In the treatment main frame also with the x ray generator in the traditional analog positioning equipment with image intensification system is integrated is installed in this equipment rotary body, not only save grand master pattern and drafted a cover complexity of an equipment, multiple Mechatronic Systems, also solved simultaneously a big technical barrier of clinical radiation oncology circle of long-term puzzlement, the patient that terminated moves and pendulum position process of reconstruction and the treatment error introduced, has started and has realized the location in same the equipment simultaneously, rebuild and the integrated revolution of treatment; Also designing in the treatment main frame rotary body has, high-energy ray solid opto-electronic conversion drifting detector matrix arrangement in order to the dosage checking, with the graphite ionization chamber detector that demarcation and safety check are used, be the another new invention that high-energy ray dosage verification system is used in radiotherapy equipment; The high-power stepper drive system of treatment main frame rotary body is made up of corresponding stepper drive motors, worm reducer, commentaries on classics tooth assembly and output shaft gear wheel.The spiral three-dimensional therapeutic bed, be through bilateral total control synchronization structure, therapeutic bed is installed on the central axis such as grade of the interior supporting layer rotating cylinder in the treatment main frame rotary body, therapeutic bed can move 300mm in X-direction, Y direction moves 200mm, Z-direction moves 2400mm, and the treatment lathe bed is by forward and backward guide rail and drive screw mandrel, and assembly such as forward and backward lathe bed drive system is formed.Central control board is being controlled structural systems such as 24 conformal intensity modulated (4 * 6) full digital beam independence neuron stepping automatic control systems, the independent neuron full digital stepping automatic control system of therapeutic bed five dimensions, the two-dimentional stepping automatic control system of X-ray door screen of simulating navigation system, the high-power stepper drive of treatment main frame system, CCD video image system, dosage checking scanning system.Said structure, system is with Isolated Shield therapeutic room and independently treat auxiliary facilities-multi-fault spiral three-dimensional radiotherapy treatment planning system, has constituted cobalt of the present invention-60 multi-lamination non-coplanar spiral lamination strength adjustable radiotherapy system.Its basic feature is: be equipped with on the structure sheaf rotating cylinder of treatment main frame rotary body and wait center, non-coplane, confocal point to be used to carry out a plurality of cobalts-60 radioactive source that spiral-fault shines, and and radioactive source multi-leaf collimator collimator that is used as irradiation of big open country and conformal modulating radiotherapy that is complementary and the column collimator with X-cutter, gamma knife function, the high-energy ray solid opto-electronic conversion drifting detector matrix arrangement of checking CT imaging is housed on the rotary body, the patient locatees the navigation system of reconstruction, demarcates the ionization chamber detector of using with safety check.Its additional technical feature is:
1, automatic station-keeping system or the laser orientation system of being made up of x ray generator and image acquisition conversion image intensification system is installed on treatment main frame rotary body;
2, on the structure sheaf rotating cylinder of treatment main frame rotary body, a plurality of cobalts-60 radioactive source that center, non-coplane, confocal point are used to carry out the spiral-fault irradiation is installed etc., and and radioactive source multi-leaf collimator collimator that be complementary, that be used as big wild irradiation and implementation intensity modulated radiation therapy, with cylindric collimator with X-cutter, gamma knife function, and the high-energy ray solid opto-electronic conversion drifting detector matrix arrangement of checking CT imaging is housed, the patient locatees the navigation system of reconstruction, demarcates the ionization chamber detector of using with safety check;
3, on the structure sheaf rotating cylinder of treatment main frame rotary body, a plurality of cobalts-60 radioactive source that center, non-coplane, confocal point are used to carry out the spiral-fault irradiation is installed etc., and and radioactive source multi-leaf collimator collimator that be complementary, that be used as big wild irradiation and implementation intensity modulated radiation therapy, with cylindric collimator with X-cutter, gamma knife function, on other aspects of rotary body, the high-energy ray solid opto-electronic conversion drifting detector matrix arrangement of checking CT imaging is housed, the patient locatees the navigation system of reconstruction, demarcates the ionization chamber detector of using with safety check;
4, be contained in the three-dimensional therapeutic bed for the treatment of in the main frame a rotating body supporting layer rotating cylinder, be through bilateral total control synchronization structure, one end is equipped with control this edge of bed X, Y, the motion of Z direction, the other end is controlled it and is synchronized with the movement along X, Z direction, implement the independent neuron full digital stepping automatic control system of localized five dimensions, realize the location and the stepping spiral function of therapeutic process;
5, on the structure sheaf rotating cylinder of treatment main frame rotary body, install etc. center, non-coplane, confocal some cobalt-60 source, be a kind of with the vertical XZ section of rotary body body on be isogonism and arrange, and every adjacent two sources are at the radioactive source at 10~30 ° of angles of Y direction dislocation;
6, the rotation position two-layer concentric rotating cylinder of treatment on the main frame supports the rotating cylinder end at internal layer the commentaries on classics tooth is housed, and changes tooth with the output shaft of drive motors, reductor and is complementary, and constitutes the rotating mechanism of rotary body;
7, to carry be three layers of concentric rotating cylinder in the rotation of treatment on the main frame, and the commentaries on classics tooth is housed on outer rotating cylinder, changes tooth with the drive motors output shaft and be complementary, and constitutes the another kind of rotating mechanism of rotary body;
8, on the structure sheaf rotating cylinder of treatment main frame rotary body, be equipped with and wait center, non-coplane, confocal point, on the XZ section, be 60 ° of angles layouts, 6 cobalt-60 radioactive sources at the 12 ° of angles that misplace each other in adjacent two sources of Y direction.
The therapeutic process of native system is: at first need diagnosis pictorial data that patient is carried, handing over has doctor and physics teacher to determine interesting areas and sends to and do optimality analysis, calculates the energy fluence of sending to according to iterative algorithm and distributes.The doctor is according to the data of patient diagnosis, by three-dimensional radiotherapy treatment planning system, clinical kitchen range that calculated in advance need be shone well and subclinical kitchen range radiate wild shape, beam weights, treatment time, irradiated volume dosage, avoid treatment parameter and machine control parameters such as radioactive area, the suffered maximum volume dose limitation of vital tissue organ.In second step, system except will whether being in normal operating conditions to equipment every day carries out the conventional detection, and first step of actual therapeutic is to carry out the location of machinery and the measurement of dosage controlling party face by a phantom.Patient is when accepting to handle for the first time, and the location is just finished in the imaging of X ray projection-type, finishes reference mark simultaneously.Determining of relative position when gradation was handled after this labelling was mainly used in, and Rapid Dose Calculation is carried out in new position.Next step will carry out a preliminary scanning, so that obtain the parameter of one group of data for projection or patient location.The data of scanning go on record the reference position as with post processing the time, and with projector space as patient's basis on location and the position reference of handling as later gradation.Got off by computer recording together in the locator data and the reference position that obtain in output detector, for use in Three dimensional rotation and the mobile data of determining patient, thus the three-dimensional contour line when determining patient.In case after being determined with respect to the contour line of reference system, these makeover process do not need to remake the optimization search.Because the optimization search needs for a long time, and the calculating that this positional parameter changes only needs several seconds.The 3rd step, radiotherapy treatment planning system will pass through data network, above-mentioned parameter is delivered to the central control board of this therapy system, central control board will be controlled therapeutic bed automatically, make patient's focal zone be positioned at treatment main frame rotary body etc. the center, the doctor can be by means of the X-ray machine and the image amplifier of this system, confirms again and the accuracy of plan for adjustment system data and focal zone anchor point.The characteristics of native system are to use same system, the projected image in can obtain medical treatment preceding, treatment back and the treatment.These data can be used to confirm patient's location and explain therapeutic effect, if necessary, can also rebuild dose distribution.The another one important function is the dose distribution of confirming in the treatment plan.Among confirm the dose distribution of the actual institute of patient exposure is provided, thereby can compare intended dose and therapeutic dose.Send to wrongly if in treatment, find dosage, can stop treatment immediately.The final step of treatment is to implement treatment plan.After all buckets of preparation before treatment were accurate, all these information all were sent to control station and synchronous control system.Implementing treatment stage, Synchronization Control, the control of treatment scanning bracket, the control of collimator diaphragm and patient's bed motion are controlled all synchronization actions.Here the step of affirmation is all arranged and information is delivered to security system with each system.Security system supervision overdose process is closed radioactive source in case of necessity.In each step of above-mentioned steps, all information to be stayed in the data collecting system that links together with detector, these data will be used for post processing.The spiral-fault intensity modulated radiation therapy system starts treatment main frame rotary body automatically by preset program, and the 6 cover diaphragm collimator and the cylindric collimators in 6 sources of dynamic modulation simultaneously, makes the intensity of radiation field size, position close with the shape of various dose irradiated region; And the suitable shape of foundation is avoided principle of radiotherapy; with pneumatic mode 6 radiogenic open and closed are carried out dynamic modulation; seek minimum dose protection to adjacent organs and normal structure; at 6 radiographic sources is the continuous rotation therapy while at center with patient; 3d orbit therapeutic bed carrying patient; passed through by programme-control stepping in therapeutic equipment; realize multidimensional face, confocal spiral-fault intensity modulated radiation therapy process; the doctor gathers and stores the significance map image data and check reconstruction in order to treatment next time under the monitoring of visible image.The data of missing the season that post processing is collected based on detector are carried out further date processing and analysis.During this period, systematic analysis mainly judges whether and need revise.Except checking, inspection and the correction of routine every day, if necessary, treatment plan can be revised before treatment next time.In this case, the adaptive radiotherapy between the interval procedure is just possible.Therefore, the physics teacher can handle relevant issues according to practical situation.After finishing these steps, before treatment next time, just can judge and carry out the correction of necessity.All parameters such as the high gradient dose distribution in the intensity modulated radiation therapy, patient's the position and the affirmation of treatment plan, all are the important contents in the radiotherapy.Projected image is very important to checking patient's body inner structure and location.The Rapid Dose Calculation of finishing a treatment planning systems need make patient all do projection image before treatment, in the middle of treatment back and the treatment.Especially the vicissitudinous case of the anatomical structure of tumor between the interval procedure.Therefore, it is very important being combined in projection image and therapy apparatus in the machine.In suitable shape tomography radiotherapy, the CT imaging of WV magnitude is possible, though because detector efficiency is low, the accumulated dose when treating is bigger, total statistical error unlike the image difference of KV magnitude what.Yet the Image Reconstruction Technology of MV magnitude is still among exploitation.The present invention has embodied a concentrated reflection of up-to-date thought and the state-of-the-art technology that occurs in the world's radiation oncology and neurosurgery medical domain in recent years.Because native system equipment has radiotherapy treatment planning system, can design treatment plan and optimal design therapeutic scheme, have navigation system such as X-ray machine and image amplifier or laser orientation system on the main frame and can realize automatic location, and etc. the non-coplane in center, six of confocal points have cobalt-60 radioactive source of multi-leaf collimator collimator and the cylindric collimator of seriation, and the therapeutic bed of synchronization control can be realized suitable shape of spiral-fault and the big wild focus irradiation that replenishes, the high-energy ray solid opto-electronic conversion drifting detector matrix arrangement of the checking CT imaging that has, the data of gathering by its are used to calculate the dosage of patient's actual absorption, to reach checking and the modification to treatment plan.And mental retardation ionization chamber radiation detector can be finished safety is guaranteed in the monitoring of dosage.
The invention has the advantages that: because this device has said structure, therefore, can provide the overall process of simulation location, treatment and checking with an equipment in a very short cycle, it includes following ability:
(1) it is compound and avoid the treatment plan function to have a three-dimensional conformal multi-fault beam;
(2) high precision location;
(3) during interval procedure, each irradiation can be revised according to the previous treatment effect;
(4) avoided reorientation to patient;
(5) has reverse CT checking imaging capability;
(6) have conformal intensity modulated irradiation and big wild compound irradiation function simultaneously;
View data when (7) using treatment is verified radiation situation;
(8) dosage after treatment is rebuild, and can verify treatment plan;
(9) can estimate treatment prescription.
Outstanding advantage of the present invention is: because this equipment can be implemented this up-to-date radiotheraping method of multi-fault spiral Intensity Modulation Radiated Therapy (IMRT): implementing suffering from the treatment all, use 6 cobalt-60 radioactive sources that same focus point is shone, the radiation dose of tumor is 6 times of single source amount of radiation, more helps improving the needs of clinical tumor fatal dose treatment; And 6 with Different Plane and etc. cobalt 60 radiographic sources installed of central circular symmetry, formed 6 unduplicated radiant cone dosage faces, the suffered dosage damage of tumor normal surrounding tissue organ be same focus put single source amount of radiation 1/6th.Therefore, this equipment scans leafy late radiotheraphy device than the single-lined fault that U.S. Cheng Sikang star university medical physics system is designing, to the raising of tumor lethal dose with lower aspect the suffered dosage damage of normal structure organ advanced more.