Delivery quality assurance (DQA) is the process of establishing a treatment plan and verifying that the pre-treatment dose is delivered without any problems through a simulation. If the result does not meet certain criteria, the dose delivered to the patient is judged to be inaccurate, and the measurement or the treatment plan should be reconsidered. Therefore, it is important to analyze the plan parameters that influence the DQA outcome. The plan parameters have been studied for LINAC-based intensity-modulated radiation therapy and the Tomo helical method but not for the Tomo direct (TD) method. In this study, we perform this investigation using the TD method. A Radixcat X9 machine was used to collect data. Furthermore, in the TD method, we set the passing rate for each gamma analysis criterion as 2%/2 mm and 3%/3 mm. Next, the plan parameters influencing the DQA passing rate were confirmed by Pearson’s correlation analysis and regression analysis. Based on the gamma analysis, the mean passing rates of 2%/2 mm and 3%/3 mm were 97.9299 and 99.8472, respectively. The plan parameters influencing the DQA passing rate during the Pearson correlation analysis were IECZ (2%/2 mm: p = 0.008), duration (2%/2 mm: p = 0.002), and planning target volume (2%/2 mm: p = 0.030 and 3%/3 mm: p = 0.034). Based on these results, a regression analysis was performed. As a result of the regression analysis, duration (2%/2 mm: p = 0.047) was identified as the most significant plan parameter for the DQA passing rate. However, statistically for the gamma analysis criterion of 3%/3 mm, there were no significant plan parameters. As the beta of the duration has a negative relationship with the passing rate, reducing the duration improves the passing rate. When confirming the passing rate for each group in a duration of 60 s, it was confirmed that the passing rate was high if it was set to less than 240 s. So, we recommend setting the duration to 240 s or less.

中文翻译：

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Radixact X9中Tomo直接法影响交付质量保证合格率的计划参数分析

递送质量保证 (DQA) 是建立治疗计划并通过模拟验证治疗前剂量是否无任何问题的过程。如果结果不符合某些标准，则判断给予患者的剂量不准确，应重新考虑测量或治疗计划。因此，分析影响 DQA 结果的计划参数非常重要。已经针对基于 LINAC 的强度调制放射治疗和 Tomo 螺旋方法研究了计划参数，但尚未针对 Tomo 直接 (TD) 方法研究计划参数。在这项研究中，我们使用 TD 方法进行这项调查。使用 Radixcat X9 机器收集数据。此外，在 TD 方法中，我们将每个伽马分析标准的通过率设置为 2%/2 mm 和 3%/3 mm。下一个，影响DQA通过率的计划参数通过Pearson相关分析和回归分析得到确认。根据伽马分析，2%/2 mm 和 3%/3 mm 的平均通过率分别为 97.9299 和 99.8472。在 Pearson 相关分析期间影响 DQA 通过率的计划参数是 IECZ (2%/2 mm: p = 0.008)、持续时间 (2%/2 mm: p = 0.002) 和计划目标体积 (2%/2 mm ：p = 0.030 和 3%/3 毫米：p = 0.034）。基于这些结果，进行了回归分析。作为回归分析的结果，持续时间 (2%/2 mm: p = 0.047) 被确定为 DQA 通过率的最重要的计划参数。然而，对于 3%/3 mm 的伽马分析标准，统计上没有显着的计划参数。由于持续时间的beta与通过率呈负相关，因此减少持续时间会提高通过率。在确认每组60s持续时间的通过率时，如果将其设置为小于240s，则确认通过率较高。因此，我们建议将持续时间设置为 240 秒或更短。