鼻咽癌调强放射治疗中自动计划与人工计划的剂量学差异
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摘要
目的 比较鼻咽癌调强放射治疗中自动计划(AP)与人工计划靶区和危及器官的剂量学差异。方法 选取24例鼻咽癌调强放射治疗患者,在Pinnacle3 9.10计划系统上分别利用人工计划和AP方法设计调强放射治疗计划,根据两种不同计划的剂量体积直方图,评价靶区和脑干、脊髓等正常组织所受剂量的差异。结果 AP和人工计划的靶区剂量分布均可以满足临床要求,靶区的D_2、D_(98)、 V_(107%)、V_(95%)差异均无统计学意义(P>0.05),但是AP靶区的D_(50)和D_(mean)大于人工计划,差异均有统计学意义(P<0.05)。人工计划中脊髓的D_(max),脑干的D_(max)、Dmean,以及左右晶状体的D_(max)均大于AP,差异均有统计学意义(P<0.05)。结论 相对于人工计划,AP能节省时间,并且能在保证靶区剂量的前提下,更好地保护正常组织。
Objective The purpose of this study was to assess the feasibility of auto-planning(AP) technology in nasopharyngeal carcinoma by comparing the dosimetry differences between the auto-planning plan and the conventional manual plan.Methods 24 nasopharyngeal carcinoma patients were selected to perform the manual plan and the AP designing by use of the Pinnacle3 9.10 treatment planning system.The study examined the variation of dose-volume histogram between the manual plan and the AP.Two plans were compared among target dose distribution and the doses received by the organs at risk.Results Compared the manual plan with the AP,no statistical difference was found in D_2、D_(98)、V_(107%) and V_(95%),but the D50 and Dmean of AP is larger than that of manual plan,and the difference is statistically significant(P<0.05). The maximum dose for spinal cord,the maximum dose and mean dose for brain stem,and the maximum dose for lens of the AP were considerably lower than the manual plan with statistical difference(P<0.05).Conclusion AP can achieve the requirement of clinical dose distribution as the manual plan.In addition,compared with manual planning,the AP groups could save more time and protect normal tissues better on the premise of target dose.
Objective The purpose of this study was to assess the feasibility of auto-planning(AP) technology in nasopharyngeal carcinoma by comparing the dosimetry differences between the auto-planning plan and the conventional manual plan.Methods 24 nasopharyngeal carcinoma patients were selected to perform the manual plan and the AP designing by use of the Pinnacle3 9.10 treatment planning system.The study examined the variation of dose-volume histogram between the manual plan and the AP.Two plans were compared among target dose distribution and the doses received by the organs at risk.Results Compared the manual plan with the AP,no statistical difference was found in D_2、D_(98)、V_(107%) and V_(95%),but the D50 and Dmean of AP is larger than that of manual plan,and the difference is statistically significant(P<0.05). The maximum dose for spinal cord,the maximum dose and mean dose for brain stem,and the maximum dose for lens of the AP were considerably lower than the manual plan with statistical difference(P<0.05).Conclusion AP can achieve the requirement of clinical dose distribution as the manual plan.In addition,compared with manual planning,the AP groups could save more time and protect normal tissues better on the premise of target dose.
引文
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[2]Batumalai V,Jameson MG,Forstner DF,et al.How important is dosimetrist experience for intensity modulated radiation therapy A comparative analysis of a head and neck case[J].Pract Radiat Oncol,2013,3(3):e99-e106.
[3]Wu B,Ricchetti F,Sanguineti G,et al.Patient geometry-driven information retrieval for IMRT treatment plan quality control[J].Med Phys,2009,36(12):5497-5505.
[4]Hazell I,Bzdusek K,Kumar P,et al.Automatic planning of head and neck treatment plans[J].J Appl Clin Med Phys,2016,17(1):272-282.
[5]Zhang X,Li X,Quan EM,et al.A methodology for automatic intensity-modulated radiation treatment planning for lung cancer[J].Phys Med Biol,2011,56(13):3873-3893.
[6]吴骏翔,康盛伟,王培,等.宫颈癌术后放疗中自动计划与人工计划的剂量学比较[J].中华放射医学与防护杂志,2018,38(1):26-31.
[7]Hansen CR,Johansen J,Kristensen CA,et al.Quality assurance of radiation therapy for head and neck cancer patients treated in DAHANCA 10 randomized trial[J].Acta Oncol,2015;54(9):1669-1673.
[8]Yuan L,Ge Y,Lee WR,et al.Quantitative analysis of the factors which affect the interpatient organ-at-risk dose sparing variation in IMRT plans[J].Med Phys,2012,39(11):6868-6878.