CN1960780B - 模块化的患者支撑系统 - Google Patents

模块化的患者支撑系统 Download PDF

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CN1960780B
CN1960780B CN2004800231212A CN200480023121A CN1960780B CN 1960780 B CN1960780 B CN 1960780B CN 2004800231212 A CN2004800231212 A CN 2004800231212A CN 200480023121 A CN200480023121 A CN 200480023121A CN 1960780 B CN1960780 B CN 1960780B
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尼克·里格尼
丹·安德森
大卫·莱西那
丹·米勒
迈克尔·莫耶斯
程齐烨
迈克·鲍曼
史蒂文·麦卡拉斯特
杰里·斯拉特
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Loma Linda University
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Abstract

一种用于将放射物精确地传递到癌症患者(108)体内的目标位置的放射治疗系统(100),包括模块化的患者支撑系统和患者定位装置(114)。该模块化的患者支撑系统包括可模块化扩展的患者容器(200)以及至少一个固定装置,例如,刚性的可模制泡沫支架(350)。患者容器(200)包括通常为半圆柱形的支撑壳体(212),支撑壳体(212)在近端边缘(214)和远端边缘(216)之间纵向延伸,并且在两个侧边缘(222、224)之间横向延伸。在一个实施方案中,侧边缘(222、224)是锥缩的,以使得在放射束穿过侧边缘(222、224)时而产生的边缘效应最小化。

Description

模块化的患者支撑系统
政府支持
本发明在美国政府的支持下开发,获得由美国国防部提供的授与DAMD17-99-1-9477和DAMD17-02-1-0205。美国政府在本发明中具有某些权利。
相关申请
本发明要求了于2003年8月12日提交的、名为“精确的患者对准与放射束治疗系统”的第60/494,699号美国临时申请以及于2004年6月10日提交的、名为“精确的患者对准与放射束治疗系统”的第60/579,095号美国临时申请的优先权,上述申请的全部内容通过引用而合并入本发明中。
发明背景
技术领域
本发明涉及放射束治疗系统,尤其涉及一种具有患者定位器的放射治疗系统。本发明涉及放射束治疗系统,尤其涉及一种模块化的患者支撑系统。本发明涉及放射束治疗系统,尤其涉及一种具有锥缩的、能够降低边缘效应(与放射束路径中的水当量(water equivalency)突然变化有关)的边缘结构的患者容器(pod)。
背景技术
放射治疗系统是公知的,用于为身患多种疾病的患者提供治疗。放射治疗通常用于杀死或抑止有害组织(例如癌细胞)的生长。定量的高能电磁放射和/或高能粒子被引导到有害组织中,目的在于破坏有害组织,同时在放射通过有用或健康组织传递到通向有害组织的路径时降低对这些有用或健康组织所造成的无意损害。
质子疗法作为一种对于多种疾病特别有效的治疗而出现。在质子疗法中,对带正电荷的质子亚原子粒子进行加速,并将其校准为高度聚焦的粒子束,然后引导向患者体内的指定目标区域。质子与电磁放射或低质量的电子带电粒子相比,在碰撞患者的组织后具有较少的横向分散,因而可更加精确地对准并沿着放射束的轴传递。在碰撞患者的组织后,质子还表现出特有的布喇格峰(Bragg peak),其中,加速质子的很大部分动能堆积在患者体内相对较窄的穿透深度内。这对于减少能量从加速的质子粒子传递到介于目标区域和质子治疗仪的输出喷嘴之间的健康组织以及传递到超出指定目标区域的“顺发射方向(downrange)”的组织来说具有显著优点。根据特定患者及其疾病的迹象,治疗用的质子束可优选地从多个治疗部分中的多个方向进行传递,以维持传递到目标区域的总剂量,同时降低其间有用/健康组织受到影响。
于1989年9月26日颁发、授予洛马林达大学医疗中心(LomaLinda University Medical Center)、名为“多台质子束治疗系统(MULTI-STATION BEAM THERAPY SYSTEM)”的第4,870,287号美国专利说明和阐述了一种放射束治疗系统。该专利中描述的系统包括几个不同的治疗台,每一个治疗台都包括台架,用于支撑并绕静止的患者在旋转轴线上旋转放射束发送和传递系统,以从几个不同角度将治疗放射束传递到患者体内的预定目标等角点(isocenter)。
通过许多放射治疗系统和方案,首先为每个癌症患者制定独特的治疗计划。例如,在治疗计划(例如,质子放射治疗)的制定中,患者通常被放置在支撑台或支撑结构上,而通过以成像技术(例如,计算机化断层(CT扫描))扫描来进行患者身体的内部分析(anatomy)。通过对成像设备形成的图像进行分析,以精确定位癌症的位置,从而为放射束限定目标。在很多情况下,医生制定出放射治疗计划,需要许多具有不同大小、持续时间以及方位角的放射束的不同的患者治疗阶段。
由于世界上有大量可能受益于放射治疗的癌症患者,而只有相对少量的高级的放射(例如,质子)治疗设备和系统,因此,放射治疗提供者需要在他们现有设备基础上进行较多的患者处理量。同样地,需要使用自动或机器人的患者定位装置的患者支撑和定位系统,从而使放射治疗提供者能够提高患者处理量。
对于每个治疗阶段,使患者支撑在与治疗计划的制定中使用的初步成像或扫描阶段完全相同的位置(即,原始位置)是很重要的。因此,需要患者定位和再定位支撑系统,用于在放射治疗期间将患者固定地安放在原始位置,以及在随后的放射治疗阶段期间将患者再定位于相同的原始位置。对于一些需要对患者身体的不同部分从几个不同角度进行照射的应用来说,理想的情况是,患者定位和再定位支撑装置能够固定地安放患者。
对于给定患者的放射治疗方案可依赖于多种因素,例如包括:患者的体型大小和身体特性;被照射的肿瘤的类型、大小以及位置;以及治疗方案的危害性(aggressiveness)。同样地,需要一种能够容易地进行调节以适应大量的治疗方案的模块化的患者支撑系统。
对于某些治疗方案来说,需要将放射束以一定角度进行引导,使其能够穿过患者容器(patient pod)的至少一个横向边缘。因此,需要能够在通过或接近容器横向边缘的放射束的强度或亮度方面减少不连续性的容器边缘结构。
发明内容
根据本文描述的一个实施方案,提供了一种放射治疗系统,用于将规定的放射剂量传递到癌症患者体内的目标位置,并用于提高患者通过量水平(throughout level)。该治疗系统包括:患者治疗台;台架、放射束源;喷嘴(nozzle);模块化的患者支撑系统;患者定位装置;以及控制系统。
在一个实施方案中,放射束源包括质子源以及用于使得质子加速为质子束加速器。
根据本文描述的一个实施方案,提供一种模块化的患者支撑系统,用于在放射治疗期间将癌症患者有效固定至固定位置。该支撑系统包括模块化的患者容器。
根据本文描述的一个实施方案,提供一种模块化的患者容器,用于为经受放射治疗的癌症患者提供悬臂式支撑。该容器包括:纵向延伸的支撑壳体;近端延伸部分导轨;远端延伸部分导轨;以及定位装置-容器连接器。
在一个实施方案中,支撑壳体由治疗穿透材料(例如,碳纤维)制成。
在一个实施方案中,远端壳体附着物与远端延伸部分导轨相接合。在另一个实施方案中,近端容器附着物与近端延伸部分导轨相接合。
根据本文描述的一个实施方案,提供一种模块化的患者容器,其配置为能够降低任意的边缘效应。该容器包括支撑壳体,其具有第一侧边缘和第二侧边缘。
在一个实施方案中,第一侧边缘包括第一锥缩的边缘和由第一低密度材料(例如,微球体环氧树脂)制成的第一轨道。在另一个实施方案中,第二侧边缘包括第二锥缩的边缘和由第二低密度材料制成的第二轨道。
附图的简要说明
图1是具有机器人(robotic)患者定位系统的放射治疗系统的一个实施方案的示意图;
图2是具有机器人患者定位系统的放射治疗系统的另一个实施方案的示意图;
图3是机器人患者定位装置的一个实施方案的侧视等距视图(isometric view);
图4A是模块化的患者容器的一个实施方案的等距放大(elevated)侧视图;
图4B是图4A中的患者容器的横断面图;
图4C是图4B中的容器外壳横向边缘的特写剖视图;
图5是模块化患者支撑系统的一个实施方案的横断面图;
图6是定位装置-容器连接器的等距放大侧视图;
图7A是较短的平坦附着物的一个实施方案的等距放大侧视图;
图7B是较长的平坦附着物的一个实施方案的等距放大侧视图;
图7C是壳体的腿或头部延伸部分的一个实施方案的等距放大侧视图。
图7D是适合于固定装置的平坦延伸部分的一个实施方案的等距放大侧视图。
图7E是较短的头部支撑延伸部分的一个实施方案的等距放大侧视图。
图7F是定位装置端延伸部分的一个实施方案的等距放大侧视图。
图7G是俯卧头垫的一个实施方案的等距放大侧视图。
图8是模块化患者支撑系统和相应的可瞄准体积(aimable volum)的一个实施方案的示意性局部剖面侧视图。
优选实施方案的详细描述
A.具有机械化患者定位装置的放射治疗系统
根据本文描述的一个实施方案,提供一种具有患者定位装置的放射治疗系统。
现在将参照附图,其中,在整个附图中类似的附图标记表示类似的部件。图1示意性地表示了放射治疗系统100的一个实施方案。放射治疗系统100被设计为相对于患者的一个或多个角度或方位将治疗用的放射剂量传递到癌症患者108体内的目标区域,用于治疗恶性肿瘤或其它疾病。
在一个实施方案中,放射治疗系统100被设计为将质子束的治疗用剂量传递到患者体内的目标区域。关于这种系统100的结构以及操作的其它细节可在名为“多台质子束治疗系统(MULTI-STATIONPROTON BEAM THERAPY SYSTEM)”的第4,870,287号美国专利中找到,该专利的全部内容通过引用而合并入本发明中。在另一个实施方案中,系统100被设计为传递任何其它本领域公知的临床上合适的放射,例如,x射线、伽马射线、强子、中子等。
放射治疗系统100通常包括患者治疗台以及台架102,台架102包括通常为半球形或截头圆锥形的支架,用于附着和支撑放射治疗系统100的其它组件。关于台架102的结构以及操作的其它细节可在名为“辊支撑、模块化、等角的台架及其组装方法(ROLLER-SUPPORTED,MODULAR,ISOCENTRIC GENTRY AND METHOD OFASSEMBLY)”的第4,917,344号和第5,039,057号美国专利中找到,这两个专利的全部内容通过引用而合并入本发明中。
继续参照图1,在一个实施方案中,系统100还包括喷嘴110,喷嘴110由台架102附着和支撑为可绕台架等角点120相对精确地旋转。系统100还包括传递治疗用的放射束的放射源106,例如,穿过设置于喷嘴110末端上的孔110并由孔110定形的加速质子束。数字146表示放射束的路径。上述孔优选地根据患者的治疗用放射疗法的特殊处方而进行设定。
继续参照图1,系统100还包括一个或多个成像仪112,在这一实施方案中,成像仪112可在延伸位置和缩回位置之间相对于台架102伸缩。这里所示的成像仪112处于延伸位置。在一个实施方案中,成像仪112包括固态非晶硅x射线成像仪,其能够例如从已经穿过患者身体的入射x射线放射而生成图像信息。系统100还包括x射线源130,其选择性地发射适当的x射线放射,x射线放射穿过患者内部的组织,以经由成像仪112生成内部材料的射线照相(radiograph)图像。成像仪112的可伸缩特征提供了这样的有益效果,即,在不需要成像仪112的时候,能够从放射源106的放射束路径收回成像仪屏幕,从而能够在台架102的封闭内部提供额外的空隙,并且能够将成像仪112置于放射源102的潜在有害的发射路径之外,从而能够降低对成像仪112进行屏蔽的需求。在这一实施方案中,成像仪和放射源130正交排列,以从两个方向提供患者的射线照相图像。
系统100还包括患者定位装置114以及患者容器200,患者容器200在末端(患者定位装置114的工作端116)附着到定位装置-容器连接器234。在收到适当的移动命令时,患者定位装置114适合于将患者容器200在多个平移轴线和旋转轴线上定位,并优选地能够在三个正交的平移(即,纵向、竖立和横向)轴线以及三个正交的旋转轴线(即,俯仰、滚动和偏转)上对患者容器200进行定位,以便为患者容器200提供全部的六个自由度运动位移。
可以理解,可以多种方式对患者进行定位,包括但不限于:自动、半自动(例如,通过手动悬制(hand pendent))、通过与定位装置控制器的直接交接而人工控制、或者完全人工(例如用手摇柄释放制动以及移动各个装置轴)。
参照图2和3,在一个实施方案中,患者定位装置114包括机器人臂150,例如KUKA KR500-L420机器人。在一个实施方案中,KUKAKR500-L420机器人安全地安装在位于转动平台132下方的坑中的支座上,并且穿过平台132中的切口134而向上延伸。平台132通常与治疗区域地面130齐平。机器人臂150通常能够在六个自由度上移动,并且能够获得在台架102中所有可能的治疗位置。机器人臂150在底座118和末端(工作端116)之间延伸。
机器人臂150的末端116处的旋转接头152能够以顺时针或逆时针的方式转动连接到其末端的任何装置。旋转接头152通常与定位装置-容器连接器234交接,定位装置-容器连接器234随后与患者容器200相连接。机器人臂的节162以及任何末端设置的臂组件能够绕旋转接头154转动。机器人臂的节164以及任何末端设置的臂组件能够绕旋转接头156转动。机器人臂的节166以及任何末端设置的臂组件能够绕旋转接头158转动。机器人臂的节168以及任何末端设置的臂组件能够绕旋转接头159转动。机器人臂的节170以及任何末端设置的臂组件能够绕旋转接头160转动。
参照图2,在一个实施方案中,放射治疗系统100包括成像仪112,成像仪112处于缩回位置或状态,因此在图中不可见。患者定位装置114安装于位于旋转平台132下方的坑中的支架上。平台132通常与治疗区域地面130齐平,并通常在定位装置114的底座118处跟随定位装置114旋转运动。定位装置114的机器人臂150穿过平台132中的切口134向上延伸。在一个实施方案中,如图2和3所示,平台132在顺时针或逆时针的方向上转动,并且绕旋转接头160旋转运动。
参照图2和5,在一个实施方案中,放射治疗系统100包括与患者定位装置114交接的、模块化的患者支撑系统199。更具体地,机器人臂150的末端116与患者容器200交接,下面将更详细地进行描述。
系统100通过控制系统处于管理和操作员控制之下,控制系统在该系统作为洛马林达大学医疗中心200MeV同步加速器设备而使用后通常被模式化(patterned)。控制系统提供操作员可控制的系统,用于控制台架102的旋转位置,以及控制患者定位装置114的平移和旋转位置。控制系统为整个系统100提供定时脉冲。
在一个实施方案中,控制系统包括多个分布式的基于微处理器的系统,它们使用局域网(LAN)标准联网在一起,并且连接到工作站计算机。LAN是基于以太网的协议。工作站执行来自治疗系统中的治疗台的放射束请求的集中式协调,并执行程序化放射束能量控制。
关于放射治疗系统的结构和操作的其它细节可在与本发明同时提交的、名为“在放射治疗环境中工具移动的路径计划和冲突避免(PATHPLANNING AND COLLISION AVOIDANCE FOR MOVEMENT OFINSTRUMENTS IN A RADIATION THERAPY ENVIRONMENT)”(申请号:未知,代理人记录号:LOMARRL.134A)以及与本发明同时提交的、名为“用于放射治疗系统的具有外部测量和对象坐标的患者对准系统(PATIENT ALIGNMENT SYSTEM WITH EXTERNALMEASUREMENT AND OBJECT COORDINATION FOR RADIATIONTHERAPY SYSTEM)”(申请号:未知,代理人记录号:LOMARRL.135A)的联名申请中找到,这两个专利的全部内容通过引用而合并入本发明中。
B.模块化患者支撑系统:
根据本文描述的一个实施方案,提供了一种模块化患者支撑系统,其通常包括模块化的患者容器以及固定装置。
图4A和4B描述了用于放射治疗的模块化患者容器200的一个实施方案。容器200包括纵向延伸的壳体结构212。在本实施方案中,定位装置-容器连接器234从壳体结构212的中部偏离,从而使得容器200相对于患者定位装置114的工作端116而悬置(cantilever)。相对于患者定位装置114而悬置的容器200有利地使得能够在放射治疗系统100内部以多种方式来定位患者。在容器200和/或定位装置114在系统100内部进行调节时,悬置的容器200有利地降低了与系统100的其它组件碰撞的机会。被悬置的容器200还能够有利于患者进入容器200或被安置在容器200中。在另一个实施方案(未示出)中,连接器234沿着容器200的纵轴线设置在壳体结构212的中部处或中部附近。
容器200、其任意组件及其任意延伸部分或附着物将在本文中参照容器200的、通过定位装置-容器连接器234而与患者定位装置114交接的部分而进行描述。沿着容器200的虚拟的纵轴线接近于连接器234的组件、延伸部分或附着物在本文中被称作“近端的(proximal)”,而位于朝向容器的相对端的组件、延伸部分或附着物在本文中被称作“远端的(distal)”。
纵向延伸的壳体结构212在壳体近端边缘214和壳体远端边缘216之间延伸。壳体212具有横向凹顶面218以及横向凹底面220。壳体212在第一向上延伸的侧边缘222和第二向上延伸的侧边缘224之间横向延伸。
参照图4A和4B,在一个实施方案中,支撑壳体212是半圆柱结构,起到了在放射治疗期间对患者进行悬臂式支撑的作用。这里,在与固定装置(例如,泡沫插入物或真空袋,下面将进行更详细的描述)一起使用时,壳体212的半圆柱形状能进行增强的物理支撑和一致的索引(index)。容器200的弯曲形状还能够使得放射束定形装置设置在患者附近。
患者能够以任意的姿势被安置在患者容器200中。在一种方法中,当患者以仰卧姿势(其头部接近于壳体远端边缘216,而其脚部接近于壳体近端边缘214)被安置在容器200中时,侧边缘222位于患者的右侧,而侧边缘224位于患者的左侧。在另一种方法中,当患者以俯卧姿势(其头部接近于壳体远端边缘216,而其脚部接近于壳体近端边缘214)被安置在容器200中时,侧边缘222位于患者的左侧,而侧边缘224位于患者的右侧。在另一种方法中,当患者以仰卧姿势(其脚部接近于壳体远端边缘216,而其头部接近于壳体近端边缘214)被安置在容器200中时,侧边缘222位于患者的左侧,而侧边缘224位于患者的右侧。
参照图4A和4B,在一个实施方案中,容器200包括分别位于壳体边缘214和216上的附着物或延伸部分导轨226和228。延伸部分导轨226和228可包括公知的通用的附着机构(universal attachmentmechanism),例如,多个线性排列的孔230、232,孔230、232能够促进壳体212的顶面和底面218、220之间的连通。在一个实施方案中,一个或多个模块化延伸部分通过可拆卸销子或螺栓放置或螺旋通过孔230、232而被可调节地固定至附着物导轨226、228。
在一种涉及对患者头部区域附近进行治疗的使用方法中,患者被安置为其头部超过壳体边缘216,位于附着到导轨228的头部支持延伸部分310上。在另一种涉及对患者的肺部区域进行治疗的使用方法中,患者被头先向前地(即,头部接近于壳体边缘216)安置,其肩部与导轨228在同一条线上,这样使放射束能够穿过壳体212并进入到肺部区域中。在另一种涉及对患者的肺部区域进行治疗的使用方法中,患者被头先向前地安置,其肩部超过导轨228,使得治疗发生在壳体212的外部。
如本文中所使用的那样,负斜斜(negative pitch)通常指的是降低或倾斜容器200的远端,而正斜斜(positive pitch)通常指的是升高容器200的远端。负滚动(negative roll)通常指的是容器200逆时针方向转动,而正滚动(positive roll)通常指的是容器200顺时针方向转动。负偏转(negative yaw)通常指的是容器200关于轴线-6向左转动,而正偏转(positive yaw)通常指的是容器200关于轴线-6向右转动。
优选地,壳体212足够长而且足够宽,以接纳大多数或所有的以任何姿势(例如,仰卧或俯卧姿势)躺在其上的人类患者身体。不具有附着物的壳体结构212的从轴线-6到远端边缘216的长度通常在约75厘米到约175厘米的范围内,常常为约80厘米到约125厘米,取决于预期患者应用的特定大小(例如,儿科)和/或台架大小。在一个实施方案中,壳体212的从轴线-6到远端边缘216的长度大约为90厘米。如本文中使用的那样,轴线-6指的是定位装置114的、垂直延伸通过定位装置114的最终偏转轴线处的附着物(例如,肘节)的轴线(例如,在如图2和3中所示的实施方案中,肘节包括在机器人臂150的末端116处的旋转接头152),从而使得患者容器200能够偏转旋转。
壳体212的总体纵向长度(即,壳体近端边缘214和壳体远端边缘216之间)通常在约90厘米到约235厘米的范围内,常常为约95厘米到约175厘米。在一个实施方案中,壳体212的总体纵向长度约为106厘米。壳体212的外直径通常在约35厘米到约65厘米的范围内,常常为约35厘米到约55厘米,取决于预期患者应用的特定大小(例如,儿科、较大患者等)和/或有效的治疗能量。在一个实施方案中,壳体212的外直径约为46厘米。
在一个实施方案中,壳体212具有非金属(例如,碳纤维)复合结构,其能够促进通过壳体212进行的放射束治疗。本领域中公知的许多成像模拟装置(例如,计算机化断层成像(CT)、正电子发射层析X射线摄影法(PET)、磁性共振成像(MRI)、锥面光束成像等)可用于说明壳体212的治疗穿透(treat-through)材料。如本文中所使用的那样,术语“治疗穿透”通常指的是这样的材料或表面的物理性质,即,其使得放射束能够通过表面照射,从而将规定的放射剂量从放射源通过表面传递到位于表面另一侧的患者体内的目标区域中。治疗穿透性质通常根据水的分子当量(molecular equivalence)来测量和量化。如本文中所使用的那样,术语“非治疗穿透”通常指的是这样的材料或表面的物理性质,即,其不能使得放射束通过表面照射。由非金属材料制成的壳体212的区域通常被称作治疗穿透表面或区域。
如本文中所使用的那样,水当量通常指的是吸收材料对质子束相对于水的作用范围。关于本文描述的治疗穿透部分、区域或表面,相对于垂直于可穿透表面的放射束而对水当量进行测量。
在一个实施方案中,如图4C所示,壳体212包括密封在结构表层242中的芯部材料240。芯部材料240可包括本领域公知的任何适当的低密度材料,例如,结构泡沫等等。结构表层242可包括本领域公知的任何适当的坚固的轻量材料,例如,碳纤维、光谱纤维等。
于2004年6月25日提交的、名为“用于记录和固定的方法和装置(METHOD AND DEVICE FOR REGISTRATION ANDIMMOBILIZATION)”的第60/583,063号美国临时申请公开了一些能够制成壳体212的适当材料,该申请的全部内容通过引用而合并入本发明中。
在一个实施方案中,壳体212由聚氯乙烯(PVC)等制成。在另一个实施方案中,壳体212由玻璃纤维等制成。在另一个实施方案中,壳体212包括任何公知的适当的低密度泡沫等。
在一个实施方案中,壳体212由复合表层构成,并包括嵌入环氧树脂和低密度聚苯乙烯泡沫(Styrofoam
Figure 048231212_0
)核芯中的聚乙烯纤维。可用于制造壳体212的一些材料的列表在下面的表I中示出。
# 基质 纤维类型 纤维结构
1 耐冲击聚苯乙烯(HIPS) n.a.
2 聚甲基丙烯酸甲酯(PMMA) n.a.
3 聚碳酸酯(PC) n.a.
4 聚氯乙烯(PVC) n.a.
5 聚乙烯(PE) n.a.
6 环氧树脂 n.a.
7 环氧树脂 玻璃纤维 任意
8 环氧树脂 玻璃纤维 编织
9 环氧树脂 芳族聚酰胺 编织
10 环氧树脂 UHMW PE 单向带
11 环氧树脂 斜纹编织
12 环氧树脂 单向带
13 环氧树脂 超高模数碳 单向带
在一个实施方案中,碳纤维复合物,其每一层叠的编织厚度约为0.25毫米厚。在一个实施方案中,复合物层叠在重量上约有50%的纤维和50%的树脂。在一个实施方案中,复合物的纤维含量为最大,而树脂含量为最小。在一个实施方案中,容器200的壳体212由复合材料范围(Spectra)制成,该复合材料可从弗吉尼亚州的科勒内尔岗的哈尼维尔品质纤维公司(Honeywell Performance Fibers in ColonialHeights,Virginia)得到。
在一个实施方案中,延伸部分导轨226、228中的至少一个由本领域公知的任何合适的金属制成,例如铝。但是,金属的使用会导致非治疗穿透区域或范围。同样地,金属结构的使用通常受到限制,以便最小化非治疗穿透表面。在另一个实施方案中,导轨226、228中的至少一个由本领域公知的合适的非金属材料制成,例如,碳纤维复合材料。
延伸部分导轨226、228有利地设置在容器200的壳体边缘214和216处,从而有利于穿过容器200的支撑壳体212的放射治疗。延伸部分导轨226、228设置在壳体边缘214和216处还能够促进一个或多个容器延伸部分附着至容器200,下面将进行更详细描述。
在一个实施方案中,延伸部分导轨226、228是圆的,使得对于某些治疗姿势来说,患者不会由于其与导轨226或228的接触而经受疼痛或不适。延伸部分导轨226、228优选地包括交接延伸部分,其近似地与壳体212的内表面218齐平。在一个实施方案中,内表面218和导轨交接延伸部分之间的最大距离或垂直距离约为1厘米。
延伸部分导轨226、228使得一个或多个容器延伸部分能够连接到容器200,并为整体设计提供模块性。例如,导轨228能够适应多个头部延伸部分,并允许2-pi头部和颈部治疗。容器组件以及可选的容器延伸部分的模块性适应于容器220内部的多个患者姿势,例如,头先向前以及脚先向前治疗姿势。容器200还适应于患者仰卧、侧卧或俯卧的治疗姿势以及这些姿势的任意改型。应该注意到,患者在容器200内部的实际姿势将取决于不同因素,例如,由内科医生或放射物理学家确定的放射治疗方案以及患者的身体特性。
参照图4A、4B和6,在一个实施方案中,定位装置-容器连接器234是刚性底座元件,其能够通过例如定位装置114的末端的工作端116而连接到任何患者定位装置114。连接器234包括定位装置交接安装板236,用于将容器200连接或附着到患者定位装置114。安装板236包括多个以环形方式排列的阴端部238,用于接纳螺栓或其它适当的固定装置,从而将容器200固定地安装至定位装置114。安装板236的这一特殊的实施方案特别适合于在KUKA KR500-L420机器人定位装置上可用的螺栓模式。
在一个实施方案中,连接器236(例如安装板)以大约1.75英寸的高度H伸入到壳体212中、在该机器人连接上沿着壳体212延伸大约12英寸的纵向长度、并且具有约11英寸的宽度W。在另一个实施方案(未示出)中,该连接器集成到壳体212中,并且与壳体212的内表面的轮廓齐平。
应该注意到,在偏转治疗角度期间,容器200和安装于其上的任何机械装置应该设置为能够避免与定位装置114相碰撞。壳体212的内表面218和连接器234之间的距离通常在约5毫米到约35毫米的范围内,常常为约12毫米到约25毫米。在一个实施方案中,壳体212的内表面218和连接器234之间的距离约为19毫米。
患者容器200可包括一个或多个附着物、延伸部分、衬板(adapterplate)等及其组合(通称为“容器附着物”)。在一个实施方案中,如图4A所示,容器200包括悬置的头部支撑延伸部分310以及机器人端、脚部支撑延伸部分320。在另一个实施方案中,如图2所示,容器200包括仰卧头部延伸部分258以及机器人端延伸部分320。
参照图7A-7G,一个或多个容器附着物能够可拆卸地附着到容器延伸部分导轨226、228中的一个或两个上。在一个实施方案中,将容器附着物附着到容器200的延伸部分导轨226、228或从其拆卸不需要工具。容器附着物优选地包括治疗穿透材料和表面。
虽然这些容器附着物可具有水当量厚度变化的治疗穿透表面,但是优选地,治疗穿透表面的水当量厚度沿着任何横向距离不会大于约0.5毫米水当量厚度/毫米的倾斜度变化。该倾斜度界限将限定设计边缘效应、厚度改变和材料过渡以及普通制造公差,例如空隙和材料表面缺陷。在一个实施方案中,附着物具有不超过2厘米的水当量。在一个实施方案中,由于安装了附着物导轨226或228,壳体212具有约25毫米宽度的非治疗穿透区域。应该注意到,在导轨226、228由金属制成的某些实施方案中,导轨为非治疗穿透的,而在导轨226、228由非金属材料(例如,碳纤维)制成的某些其它实施方案中,导轨226、228具有治疗穿透区域。如同壳体212一样,由于导轨226、228,使得某些容器可包括达到约25毫米宽度的非治疗穿透区域。
参照图7A-7G中所示的实施方案,容器附着物270、280、290、320、330中的每一个都包括与延伸部分导轨226和/或228交接并连接到延伸部分导轨226和/或228的延伸部分导轨接合端262。导轨接合端262包括上唇缘264和下唇缘266,其中,唇缘264和266之间的空间约等于延伸部分导轨226和228的内直径和外直径之间的距离。上唇缘和下唇缘264和266中的每一个都包括多个孔268,其中,每个上唇缘孔沿着从半圆柱壳体212的中心向外延伸的虚拟半径而与相应的下唇缘孔对准。在一个实施方案中,孔268被穿钻或模制到导轨接合端262内部的位置中,以在导轨接合端262与导轨226或228接合时,孔268沿着从半圆柱壳体212的中心向外延伸的虚拟半径而与延伸部分导轨孔239或232对准。在一个实施方案中,附着物270可调节,以通过可拆卸的、销子、螺栓或其等价物、通过置入或螺旋通过径向对准的孔230、232、268而固定至附着物导轨226或228。
参照图7A,在一个实施方案中,容器附着物包括较短的平坦附着物270,其具有约30厘米的长度以及约23厘米的宽度。附着物270有助于将患者以等角点定位,用于包括具有最小穿过材料的头顶(vertex)的头部治疗,并使得能够进行5度的俯仰和滚动校正。附着物270包括治疗穿透部分271和治疗穿透边缘272、273。
参照图7B,在一个实施方案中,容器附着物包括较长的平坦附着物280,其具有约48厘米的长度和约23厘米的宽度。附着物280有助于使ENT/肩部定位在远离非治疗穿透容器附着物导轨226、228的区域。附着物280包括治疗穿透部分281和治疗穿透边缘282、283。
参照图7C,在一个实施方案中,容器附着物包括壳体腿或者头部延伸附着物290,其具有大约与容器壳体212相等的直径并具有大约67厘米的长度,从而使得容器200能够容纳大约75英寸高的患者。附着物290包括端挡板或端盖294,患者的脚部能够抵靠端挡板或端盖294放置。附着物290包括治疗穿透部分291、治疗穿透边缘292、293、非治疗穿透部分295以及非治疗穿透边缘296、297。
参照图7D,在一个实施方案中,容器附着物包括平坦延伸部分300,其为约40厘米长和约36厘米宽。延伸部分300包括治疗穿透部分301、非治疗穿透部分302、303、304以及非治疗穿透边缘305、306。这里,部分301是头部支撑区域,而部分302、303、304构成固定装置附着区域。在一个实施方案中,延伸部分300适应于任意固定装置和技术,下面将进行更详细描述。例如,在一个实施方案中,延伸部分300具有的大小有助于对可选的头盖形的环进行固定安装。
参照图7E,在一个实施方案中,容器附着物包括较短的头部支撑延伸部分310。延伸部分310包括治疗穿透部分311和治疗穿透边缘312、313、314。
参照图7F,在一个实施方案中,容器附着物包括机器人端延伸部分320,其相对于在延伸部分导轨226和228的近端和远端之间延伸的虚拟的纵轴线以大约45度的角度倾斜,在距离轴线-6约19厘米处开始,直到距离轴线-6约43厘米的距离,从而防止与患者定位装置114相碰撞。延伸部分320不具有任何治疗穿透部分或边缘;部分321、322、323和边缘324、325、326都是非治疗穿透的。
参照图7G,在一个实施方案中,容器附着物包括俯卧头垫330,以适应于俯卧治疗。俯卧头垫限定出面部穿透孔331,患者可通过该孔放置其面部。俯卧头垫330包括非治疗穿透部分332、333。
许多的固定装置可与患者容器200一起使用。参照图5,在一个实施方案中,模块化患者支撑系统199包括患者容器200和固定装置,进一步包括结合至容器壳体顶面218的刚性可模制泡沫支架350。支架350与选定区域(例如,后部、前部或侧部)相符,并包括与患者身体精确相符模型352,用于在放射治疗期间牢固地固定患者。刚性泡沫支架350可通过与名为“在放射束治疗系统中使用的组装以及患者的整个身体的定位与再定位支撑方法(METHOD OF ASSEMBLYAND WHOLE BODY,PATIENT POSITIONING ANDREPOSITIONING SUPPORT FOR USE IN RADIATION BEAMTHERAPY SYSTEMS)”的第4,905,267号美国专利申请中采用的类似方式来形成,该专利申请的全部内容通过引用而合并入本发明中。
在一种方法中,被称为“ACMM起泡剂325(可从俄亥俄州阿克伦城的首乐有限公司、路兹佛罗里达或史密瑟医学产品有限公司(Soule Co.,Inc.,Lutz,Florida or Smithers Medical Products,Inc.)获得)”的可扩展的液体起泡剂可用来形成刚性泡沫支架350。在一种方法中,将起泡剂涂到壳体顶面218上。在起泡剂进入到壳体内部之后,将患者安置在壳体内部,患者静止不动地平躺约15分钟,直到起泡剂冷却到室温并形成了患者身体模型352。
患者和容器之间的泡沫可被机械地稳定,以防止泡沫在治疗之间或治疗期间移动或移位。在一种方法中,将泡沫放置在非常薄的塑料袋中。在另一种方法中,容器沿着低密度泡沫板排列。在另一种方法中,非常薄的一次性塑料壳体在应用化学泡沫之前插入到容器中。在另一种方法中,在泡沫和容器之间没有衬层;通过在高质量的铝模型上设置复合层,而使得内部容器表面被制造得非常光滑。在另一种方法中,容器的内表面涂覆有特氟纶或其它不反应物质。
其它可与患者容器200一起使用并具有或不具有平坦延伸部分的适当的固定装置包括但不限于:牙垫、面罩、真空袋、晕圈或头盖形的环、定位器Z框架盒、三角形腿垫、泡沫插入物等,或者它们的组合。牙垫嘴子(mouthpiece)优选地与现有的MRI“头部线圈(HeadCoil)”相容。在一个实施方案中,在任何方向上给定30磅的力,牙垫框架优选地能够将可治疗体积中任何位置的平移运动限制为不超过约1.0毫米。在另一个实施方案中,在任何方向上约30磅力的情况下,牙垫框架在任何方向将头部转动限制为小于或等于1度。在一个实施方案中,牙垫框架通过具有约9psi的现有的真空系统安装至壳体212和/或任何容器附着物。
关于以上描述的各种容器附着物,这些容器附着物的重量优选地不超过30磅重,从而使得单个人能够容易地携带容器附着物并将其安装至容器壳体212。安装于接近轴线-6附近的侧边缘上的容器附着物优选地沿着机器人臂或定位装置成一定角度,以消除损伤或碰撞。
在一个实施方案中,容器200能够支撑400磅分布的患者负荷(不包括固定装置),而患者的重心与轴线-6之间不超过37英寸。容器200优选地能够支撑300磅的端部负荷(具有或不具有延伸部分),以适应坐在悬置端216上的单个人。在一个实施方案中,容器200能够支撑300lbf的患者负荷、50lbf的固定装置负荷以及位于延伸部分上的200lbf的纵向负荷。
在一个实施方案中,容器200优选地能够在近端延伸部分导轨226处支撑275磅(125公斤)的充水体膜负荷(water phantom load)。
在一个实施方案中,容器200能够支撑位于附着物上(具有不超过2mm的偏差)的达到约150磅的固定装置和患者负荷。在个人坐在延伸部分上的情况下,延伸部分优选地能够在端部支撑300磅的负荷,从而使得具有延伸部分的容器不会过度弯曲。
继续参照图4A和4B,在一个实施方案中,由于患者负荷而产生的壳体212在悬置端216处的偏差优选地小于或等于约5毫米。在一个实施方案中,这种偏差可在治疗期间使用校正固有机械误差的外部测量系统进行补偿。在一个实施方案中,容器200附有或包括作为安全装置的倾斜仪(inclinometer),以防止定位装置114距水平方向产生超过约为正负5.5度的角偏差(deflection)。倾斜仪或倾斜传感器包括能够感测对象相对于重力的角度的任何装置,通常是机电装置。
由于300磅的患者分布负荷和50磅的固定装置负荷而使患者容器200在远端、悬置端(具有或不具有延伸部分)形成的垂直偏差优选地小于约4毫米。由于100磅的患者侧向负荷而使容器200(具有或不具有延伸部分)的侧向偏差优选地小于约0.5毫米。应该注意到,这类垂直偏转和侧向偏差可在治疗期间通过使用校正固有机械误差的外部测量系统进行补偿。
所有的工作台组成材料和组件优选地能够在超过20年的使用期限中承受每年52周、每周5天、约9,000拉德的平均日放射剂量。优选地,所有的硬件和组件通常在具有25-78%的相对湿度、40-95华氏度的温度环境中工作。
优选地,容器200的治疗穿透表面的厚度不变,其沿着任何横向距离每毫米具有不超过0.5毫米水当量厚度的倾斜度。容器200的治疗穿透区域的边缘优选地为小于0.5毫米的水当量厚度。在一个实施方案中,容器200的治疗穿透区域优选地具有小于约2厘米的水当量。
置于患者和射线照相图像接受器之间的容器200的组件每FDACFR部件1020优选地具有小于或等于约5毫米的铝当量。
继续参照图4A和4B,在一个实施方案中,容器200的形状和大小适合于具有68厘米物理孔以及48厘米的图像再现直径的CT扫描仪。优选地,壳体212中的治疗穿透表面厚度不变。这里,治疗穿透区域的边缘优选地小于0.5毫米水当量厚度,在一个优选实施方案中,壳体212的厚度为不超过2厘米的水当量。
容器附着物每FDA CFR部件1020优选地具有约5毫米的铝当量(通过在100千伏的峰值的电压下进行的x射线测量确定的柔度(Compliance),并具有2.7mm铝HVL的x射线束)。如本文中所使用的那样,铝当量指的是在相同的指定条件下随着所讨论的材料而提供相同的射线照相衰减的铝(类型1100合金)的厚度。应该注意到,模块化患者支撑系统199优选地能够在机器人端处适应于65厘米×60厘米×60厘米的充水体膜(water phantom)。
在一个实施方案中,放射治疗系统100包括外部测量或视觉系统,其进一步包括视觉系统标示器(maker)。视觉系统标示器优选地安装至非治疗穿透区域,例如,由金属制成的导轨226、228。
C.具有锥缩边缘结构的患者容器
根据本文描述的一个实施方案,提供一种具有锥缩边缘结构的患者容器,其能够降低与放射束路径中的水当量的突然变化相关的边缘效厘(edge effect)。
对于某些放射治疗方案来说,规定强度的放射束从侧位传递。在某些示例(例如,其中放射束从高于患者容器的侧位传递)中,放射束不必穿过患者容器来传递。在放射束从低于患者容器的侧位传递的另一种情况中,放射束能够穿过具有密度或水当量均匀的容器壳体表面。但是,存在放射束穿过一个或两个侧边缘(例如,如图4A中所示的容器壳体212的侧边缘222或224)的情况。容器壳体和容器壳体侧边缘上方的空间之间的水当量的突然过渡或变化可导致放射束的强度不一致或者难以预知。放射束路径中的水当量突然过渡所产生的影响在本文中称作边缘效应。
患者容器的侧边缘的部分可锥缩,以降低或最小化边缘效应。参照图4C,在一个实施方案中,侧边缘222包括逐步锥缩的边缘243以及纵向延伸的轨道299。锥缩边缘243包括开始于下边缘244、结束于上边缘248的向外锥缩的内表面245。锥缩边缘243还包括开始于下边缘246、结束于上边缘248的向内锥缩的外表面247。表面245和247最终在上边缘248处会聚。边缘244、246的锥缩位置和程度可根据需要变化,从而降低边缘效应。
参照图4A到4C,锥缩边缘243通常以约0.1毫米水当量/毫米到约5毫米水当量/毫米的倾斜度锥缩,取决于固定装置的精确性需求和可重复性。在一个实施方案中,锥缩部分243以0.5毫米水当量/毫米的倾斜度锥缩。
容器的侧边缘相对较薄,从而最低限度地扰动穿过侧边缘或侧边缘附近的治疗用质子束。
低密度轨道299覆盖了锥缩边缘243,从而能够保护患者和放射治疗提供者不受倾向于具有锋利边缘的上边缘248的影响。参照如图4C中所示的示例性的壳体侧边缘222,侧边缘222通常包括与锥缩边缘243的形状互补的下部(inferior portion)以及通常为圆形或钝头的上部(superior portion)。
轨道299优选地包括低密度材料,例如,微球体环氧树脂、挤压或模制塑料(尼龙、尿烷等)、橡胶等或它们的组合。在一个实施方案中,轨道299保持壳体212的0.5毫米/毫米水当量的倾斜度。
在一个实施方案中,轨道299通过本领域公知的任何附着机制可拆卸地固定至壳体锥缩边缘243,例如,用于正(positive)定位和保持轨道299的模制到壳体212中的联锁接收器。在另一个实施方案中,轨道299不通过任何附着机制的帮助而简单搁置在锥缩边缘243上。在另一个实施方案中,轨道299使用公知的适当附着机制(例如,微球体环氧树脂)而永久固定至锥缩边缘243。优选地,每个实施方案都结合了患者安全和舒适。可使用几种过渡、方法和材料(例如,可替换扶手或挠性边缘)来获得指定的倾斜度、安全和患者舒适的水平。
D.模块化患者支撑系统的可瞄准体积
可瞄准体积(aimable volume)通常取决于患者容器200和沿着正交的平移轴和旋转轴与患者容器200交接的患者定位装置114的方位。
图8提供了容器壳体212的可瞄准体积352、354(散列的(hashed))的形状的示意性局部剖面侧视图。这里,容器200在定位装置-容器连接器234的上方具有约1.9厘米的厚度。对于达到93度的偏转角度、具有或不具有俯仰或滚动校正来说,可瞄准体积(由体积352和354组成)为大约40厘米长、50厘米宽的梯形体积(沿着从轴线-6到约31.9厘米的远端高度的工作台延伸约120厘米)。当可瞄准体积的底部位于等角点处时,可瞄准体积的一半以93度的头顶位置而得到。例如,在一个实施方案中,在93度偏转的左头顶位置中,由于最大的机械延伸距离,使得患者头部(面朝上地安置,头部位于容器200的端部)的左半部分难以接近。将容器200设置到右头顶使得能够接近其左半部分。患者自身可通过横向偏移定位来消除这一现象。这里,对于头顶治疗的可瞄准体积352、354通常在离开壳体表面218约3厘米处开始。
应该理解,本文描述的本发明及其组成部件可用于多种治疗系统的组合之中,包括但不限于:质子治疗、传统的放射治疗以及成像系统(例如,CT、PET、MRI、锥面光束等)。
虽然已经根据优选实施方案对本发明进行了详细描述和说明,但是应该理解,本发明的范围并不受其限制。如本领域技术人员显而易见的那样,前述的装置和方法的特征可进行替换或增加。本发明的范围仅由所附的权利要求来限定。同时应该理解,对于本领域普通技术人员来说,结合了本发明原理的本文描述的特定实施方案的变化仍然落在所附权利要求的范围之内。

Claims (44)

1.一种模块化的患者支撑系统,用于在放射治疗期间将癌症患者有效地固定在固定位置中,以及按照放射治疗方案进行随后任意的放射治疗时将所述患者重新定位至所述固定位置,所述支撑系统包括:
模块化的患者容器,包括:
纵向延伸的、通常为半圆柱形的支撑壳体,所述支撑壳体从壳体近端边缘穿过壳体纵向中心部分延伸至壳体远端边缘,并具有底部横向凹面、顶部横向凹面、第一向上延伸的侧边缘以及第二向上延伸的侧边缘,
近端延伸部分导轨,连接至所述壳体近端边缘,
远端延伸部分导轨,连接至所述壳体远端边缘,以及
定位装置-容器连接器,在所述壳体近端边缘和壳体纵向中心部分之间附着到所述壳体底面;以及
第一固定装置。
2.如权利要求1所述的支撑系统,其中,所述第一固定装置包括刚性的可模制泡沫支架,所述支架包括与所述患者身体的至少一部分相符的模型。
3.如权利要求1所述的支撑系统,其中,所述第一固定装置包括牙垫系统。
4.如权利要求1所述的支撑系统,其中,所述第一固定装置包括面罩。
5.如权利要求1所述的支撑系统,其中,所述第一固定装置包括头盖形的环。
6.如权利要求1所述的支撑系统,其中,所述容器包括与所述远端延伸部分导轨相接合的远端容器附着物。
7.如权利要求3所述的支撑系统,其中,所述远端容器附着物包括纵向延伸的、通常为平坦的附着物,其中,所述附着物为所述患者的头部提供悬臂式支撑。
8.如权利要求3所述的支撑系统,其中,所述远端容器附着物包括纵向延伸的平坦的、包括头部支撑区域和固定装置附着区域的附着物,其中,所述附着物为所述患者的头部提供悬臂式支撑。
9.如权利要求1所述的支撑系统,其中,所述容器包括与所述近端延伸部分导轨相接合的近端容器附着物。
10.如权利要求9所述的支撑系统,其中,所述近端容器附着物包括纵向延伸的定位装置-端部延伸部分,所述定位装置-端部延伸部分相对于在所述近端延伸部分导轨和所述远端延伸部分导轨之间延伸的设想的纵轴线倾斜45度的角,其中,所述延伸部分防止所述容器同与所述容器接合的患者定位装置相碰撞,以及为所述患者的腿部区域提供悬臂式支撑。
11.如权利要求1所述的支撑系统,进一步包括第二固定装置。
12.如权利要求11所述的支撑系统,其中,所述第二固定装置包括牙垫系统。
13.如权利要求11所述的支撑系统,其中,所述第二固定装置包括面罩。
14.如权利要求11所述的支撑系统,其中,所述第二固定装置包括头盖形的环。
15.如权利要求1所述的支撑系统,其中,所述壳体包括第一治疗穿透材料。
16.如权利要求15所述的支撑系统,其中,所述第一治疗穿透材料包括碳纤维。
17.如权利要求1所述的支撑系统,其中,所述放射治疗方案包括将质子束传递至所述患者体内的目标位置。
18.一种模块化的患者容器,用于为根据治疗方案进行放射治疗的癌症患者提供悬臂式支撑,所述容器包括:
纵向延伸的、通常为半圆柱形的支撑壳体,所述支撑壳体从壳体近端边缘穿过壳体纵向中心部分延伸至壳体远端边缘,并具有底部横向凹面、顶部横向凹面、第一向上延伸的侧边缘以及第二向上延伸的侧边缘;
近端延伸部分导轨,连接至所述壳体近端边缘;
远端延伸部分导轨,连接至所述壳体远端边缘;以及
定位装置-容器连接器,在所述壳体近端边缘和所述壳体纵向中心部分之间附着至所述壳体底面。
19.如权利要求18所述的患者容器,其中,所述壳体包括第一治疗穿透材料。
20.如权利要求19所述的患者容器,其中,所述第一治疗穿透材料包括碳纤维。
21.如权利要求18所述的患者容器,进一步包括与所述远端延伸部分导轨相接合的远端容器附着物。
22.如权利要求21所述的患者容器,其中,所述远端容器附着物包括纵向延伸的、通常平坦的附着物,其中,所述纵向延伸的附着物为所述患者头部提供悬臂式支撑。
23.如权利要求21所述的患者容器,其中,所述远端容器附着物包括纵向延伸的、通常为半圆柱形的附着物,其中,所述纵向延伸的附着物为所述患者头部提供悬臂式支撑。
24.如权利要求21所述的患者容器,其中,所述远端容器附着物包括纵向延伸平坦的、包括头部支撑区域和固定装置附着区域的附着物,所述附着物为所述患者头部提供悬臂式支撑。
25.如权利要求21所述的患者容器,其中,所述远端容器附着物包括纵向延伸的俯卧头垫,其中,所述头垫限定出面部穿透孔,所述患者能够穿过所述面部穿透孔而放置其面部,其中,所述附着物为所述患者头部提供悬臂式支撑。
26.如权利要求18所述的患者容器,进一步包括与所述近端延伸部分导轨相接合的近端容器附着物。
27.如权利要求26所述的患者容器,其中,所述近端容器附着物包括纵向延伸的机械端延伸部分,所述延伸部分相对于设想的在所述近端延伸部分导轨和所述远端延伸部分导轨之间延伸的纵轴线以45度角倾斜,其中,所述延伸部分防止所述容器同与所述容器接合的患者定位装置相碰撞,其中,所述延伸部分为所述患者的腿部区域提供悬臂式支撑。
28.如权利要求26所述的患者容器,其中,所述近端容器附着物包括纵向延伸的、通常平坦的附着物,其中,所述通常平坦的附着物为所述患者的腿部区域提供悬臂式支撑。
29.如权利要求26所述的患者容器,其中,所述近端容器附着物包括纵向延伸的、通常为半圆柱形的附着物,其中,所述通常为半圆柱形的附着物为所述患者的腿部区域提供悬臂式支撑。
30.如权利要求18所述的患者容器,其中,所述放射治疗方案包括将所述质子束传递到所述患者体内的目标位置。
31.一种模块化的患者容器,其配置为能够降低在根据放射治疗方案对癌症患者进行放射治疗期间发生的任意边缘效应,所述容器包括:
纵向延伸的支撑壳体,所述支撑壳体从壳体近端边缘穿过壳体纵向中心部分延伸至壳体远端边缘,并具有底部横向凹面、顶部横向凹面、第一侧边缘以及第二侧边缘;
近端延伸部分导轨,连接至所述壳体近端边缘;以及
远端延伸部分导轨,连接至所述壳体远端边缘;
其中,所述第一侧边缘包括第一锥缩的边缘和第一纵向延伸的轨道,所述第一轨道包括与所述第一锥缩的边缘的形状互补的第一轨道下部和圆形的第一轨道上部,所述第一轨道包括第一低密度材料;
其中,所述第一锥缩的边缘有助于根据放射治疗方案通过所述第一侧边缘传递规定的放射束剂量。
32.如权利要求31所述的患者容器,其中,所述第一锥缩的边缘以从0.1毫米水当量/毫米到约5毫米水当量/毫米的倾斜度而锥缩。
33.如权利要求31所述的患者容器,其中,所述第一锥缩的边缘以0.5毫米水当量/毫米的倾斜度锥缩。
34.如权利要求31所述的患者容器,其中,所述第一低密度材料包括微球体环氧树脂。
35.如权利要求31所述的患者容器,其中,所述第一低密度材料包括尼龙。
36.如权利要求31所述的患者容器,其中,所述第一低密度材料包括尿烷。
37.如权利要求31所述的患者容器,其中,所述第二侧边缘包括第二锥缩的边缘和第二纵向延伸的轨道,所述第二轨道包括与所述第二锥缩的边缘的形状互补的第二轨道下部和圆形的第二轨道上部,所述第二轨道包括第二低密度材料,其中,所述第二锥缩的边缘有助于根据所述放射治疗方案通过所述第二侧边缘传递规定的放射束剂量。
38.如权利要求37所述的患者容器,其中,所述第二锥缩的边缘以从0.1毫米水当量/毫米到约5毫米水当量/毫米的倾斜度锥缩。
39.如权利要求37所述的患者容器,其中,所述第二锥缩的边缘以0.5毫米水当量/毫米的倾斜度锥缩。
40.如权利要求37所述的患者容器,其中,所述第二低密度材料包括微球体环氧树脂。
41.如权利要求37所述的患者容器,其中,所述第二低密度材料包括尼龙。
42.如权利要求37所述的患者容器,其中,所述第二低密度材料包括尿烷
43.如权利要求31所述的患者容器,其中,所述放射治疗方案包括使得质子束传递到所述患者体内的目标位置。
44.一种模块化的患者容器,用于根据放射治疗方案对癌症患者进行放射治疗,所述容器包括:
支撑壳体,从壳体近端边缘穿过壳体纵向中心部分延伸至壳体远端边缘,并具有第一侧边缘和第二侧边缘;
用于在所述壳体近端边缘处延伸所述容器的长度的装置;
用于在所述壳体远端边缘处延伸所述容器的长度的装置;
其中,所述第一侧边缘包括用于降低与根据所述治疗方案而穿过所述第一侧边缘的放射束相关的任意边缘效应;
其中,所述第二侧边缘包括用于降低与根据所述治疗方案而穿过所述第二侧边缘的放射束相关的任意边缘效应。
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