后备SMLC计划在鼻咽癌中的临床应用  

Clinical Application of Fallback SMLC Planning in Nasopharynx Cancer

作　　者：黄良[1] 商海焦 傅益谋[1] 金月妹[1] 

机构地区：[1]温州医科大学附属第三医院(瑞安市人民医院)放疗技术科,浙江瑞安325200

出　　处：《中国医学物理学杂志》2015年第2期286-289,共4页Chinese Journal of Medical Physics

摘　　要：目的:放射治疗过程中出现因机器故障或其他因素而需要快速调度患者在不同加速器上完成治疗。本文研究一种简单快速的方法获得一个新的后备计划,并且评估鼻咽癌后备SMLC计划剂量学特性和执行效率。方法:从XIO计划系统中选取12例已治疗鼻咽癌患者的动态调强计划(DMLC),通过Dicom RT协议传输到Raystation计划系统中,生成后备SMLC计划(Fallback Planning),评估后备SMLC计划与初始DMLC计划剂量学差异和执行效率。结果:后备SMLC计划能满足临床要求,与初始DMLC计划相比,PTV60靶区适形指数(CI)较优(P=0.010),双腮腺D50%和脊髓D1cc均较优(P=0.013,P=0.035),其它参数无显著性差异,满足临床剂量学要求;计划效率较优,有显著性差异(P=0.000)。结论:由DMLC计划生成的后备SMLC计划准确、快速、执行效率高,可以在临床上广泛使用。同时,后备计划是有望实现自动计划的另外一种方法:建立完善的患者资料数据库,当有新治疗的患者时,从数据库选取与当前患者相似的患者P信息,利用形变技术建立起对应关系,然后把数据库中患者的剂量信息映射到当前患者,进行自动计划,还可结合自适应放疗。期望后备计划在自适应计划中有更多地发展。Objective Because of the machine failure or other reasons, the fast scheduling in patients with different accelerators for treatment completion is needed during the radiotherapy. Therefore, this paper studies a kind of simple and fast method to obtain a new treatment plan and we will evaluate the dosimetric results and treatment efficiency of fallback SMLC plans in nasopharynx cancer （NPC） treatment. Methods Twelve NPC patients were selected in this study. And the SMLC plans were created by fallback planning for each patient. The target dose conformity, homogeneity, dosimetric indexes and dose to organ at risks （OARs） were compared. Results All SMLC and DMLC plans met the clinical requirements. Compared to the DMLC plans, the fallback SMLC plans showed better conformity to PTV and lower mean dose volume with double parotid and spinal cord. Conclusion Fallback SMLC plans can meet clinical requirements with better PTV conformity and higher delivery efficiency. It can be widely used in clinical area. Besides, the fallback is expected to achieve another method of autoplan： the establishment of a comprehensive database of patients. That is to say, when a patient comes, we can look at the similar patient information from the choice of database. With the relation establishing by the deformation technology, the current patient can be matched with the dose profile from the data. Also, this autoplan can be combined with the adaptive radiotherapy. The fallback planning is expected more developments in the adaptive radiotherapy field.

关 键 词：后备计划 动态调强 静态调强 多目标优化 

分 类 号：R739.6[医药卫生—肿瘤]