Monaco与Pinnacle计划系统在宫颈癌容积旋转调强计划中的剂量比较及分析  

Dosimetric comparison and analysis of volumetric modulated arc radiotherapy plan for cervical cancer based on Monaco system and Pinnacle system

作　　者：柏晗[1] 陈飞虎 李文辉[1] 李岚[1] 朱思瑾 刘旭红[1] BAI Han;CHEN Feihu;LI Wenhui;LI Lan;ZHU Sijin;LIU Xuhong(The Third Affiliated Hospital of Kunming Medical University ＆ Yunnan Tumor Hospital, Yunnan 650118, China)

机构地区：[1]昆明医科大学第三附属医院/云南省肿瘤医院,昆明云南650118

出　　处：《中国医学物理学杂志》2018年第6期654-658,共5页Chinese Journal of Medical Physics

摘　　要：目的:比较和分析基于Monaco和Pinnacle这两种计划设计系统设计宫颈癌放疗容积旋转调强(VMAT)计划的剂量差异,探寻更适用于宫颈癌VMAT计划设计的计划设计系统。方法:选取11例在云南省肿瘤医院接受根治性放射治疗的宫颈癌病人。在定位CT数据、靶区和危及器官完全一致的前提下,分别基于Monaco系统和Pinnacle系统为病人设计VMAT计划,即VMAT_(MONACO)和VMAT_(PINNACLE)。比较两个计划中靶区的剂量分布、适形指数、均匀性指数及危及器官的剂量体积差异,探讨两种TPS在设计宫颈癌根治放疗VMAT计划中的优劣,以及产生这种优劣的原因。结果:就PGTVnd和PTV的适形指数而言,VMAT_(MONACO)和VAMT_(PINNACLE)计划的差异不具有统计学意义(P>0.05)。就PGTVnd的均匀性指数而言,VMAT_(PINNACLE)优于VMAT_(MONACO),差异具有统计学意义(P<0.05)。VMAT_(MONACO)和VMAT_(PINNACLE)在直肠、膀胱的低剂量区不存在差异(P>0.05);在高剂量区域,VMAT_(MONACO)显现出优于VMAT_(PINNACLE)的趋势;在直肠和膀胱的平均剂量上,VMAT_(MONACO)明显低于VMAT_(PINNACLE),差异具有显著统计学意义(P<0.01)。VMAT_(MONACO)的小肠和股骨头的剂量明显低于VMAT_(PINNACLE),差异具有显著统计学意义(P<0.05)。结论:宫颈癌VMAT计划中,相较Pinnacle系统,选用Monaco系统设计放疗计划存在潜在的剂量学优势。Objective To compare and analyze the dose differences of volumetric modulated arc radiotherapy（VMAT） plan for cervical cancer based on Monaco treatment planning system（TPS） and Pinnacle TPS for exploring an optimal TPS to design cervical cancer VMAT plan. Methods Eleven cervical cancer patients receiving radical radiotherapy in Yunnan Tumor Hospital were selected. With the same location CT data, target areas and organs-at-risk, Monaco TPS and Pinnacle TPS were applied to design two VMAT plans for each patient, namely VMAT（MONACO） plan and VMAT（PINNACLE） plan. The dose distribution in target areas, conformity index, homogeneity index, and the dose-volume differences in organs-at-risk were compared. Finally, the advantage and disadvantage of two kinds of TPS in VMAT plan design were discussed and their causes were expounded. Results The differences in conformity index of PGTVnd and PTV didn＇t showed any significances between VMAT（MONACO）plan and VMAT（PINNACLE）plans（P〈0.05）. For the homogeneity index of PGTVnd, VMAT（PINNACLE）plan was superior to VMAT（MONACO）plan, with statistical differences（P〈0.05）. No differences were found in the low-dose area of the rectum and bladder between VMAT（PINNACLE） plan and VMAT（VMAT） plan（P〈0.05）; in high-dose areas, VMAT（MONACO）plan was better than VMAT（PINNACLE）plan. The mean doses of the rectum and the bladder in VMAT（MONACO）plan were lower than those in VMAT（PINNACLE）plan, with statistical significance（P〈0.01）. Moreover, the dose of the small intestine and the femur head were lower in VMAT（MONACO）plan as compared with VMAT（PINNACLE）plan（P〈0.05）. Conclusion Using Monaco TPS instead of Pinnacle TPS to design radiotherapy plan for cervical cancer has potential dose advantages.

关 键 词：宫颈癌 Monaco计划设计系统 Pinnacle计划设计系统 容积旋转调强 放射治疗剂量 

分 类 号：R730.55[医药卫生—肿瘤] R735.1[医药卫生—临床医学]