基于数据库的宫颈癌自动调强计划设计可行性研究  

Feasibility of automatic IMRT planning for cervical cancer based on a database of previously-treated patients

作　　者：陈济鸿[1] 柏朋刚[1] 陈文娟[1] 陈开强[1] 李奇欣[1] 张秀春[1] 戴艺涛 翁星 钱杰伟 Chen Jihong;Bai Penggang;Chen Wenjuan;Chen Kaiqiang;Li Qixin;Zhang Xiuchun;Dai Yitao;Weng Xing;Qian Jiewei(Department of Radiation Oncology,Fujian Cancer Hospital&Fujian Medical University Cancer Hospital,Fuzhou 350014,China;School of Nuclear Science and Technology,University of South China,Hengyang 421001,China)

机构地区：[1]福建省肿瘤医院福建医科大学附属肿瘤医院放疗科,福州350014 [2]南华大学核科学技术学院,衡阳421001

出　　处：《中华放射肿瘤学杂志》2020年第2期141-145,共5页Chinese Journal of Radiation Oncology

基　　金：福建省卫生健康科技项目(2017-ZQM-15、2018-ZQN-19、2017-CX-8);福建省科技计划项目(2018Y2003)。

摘　　要：目的基于重叠体积直方图(OVH)和优质宫颈癌IMRT计划数据库,研究并评估宫颈癌IMRT自动计划的可行性。方法选取200例宫颈癌患者的优质IMRT计划和OVH,建立OVH和优质计划数据库。另选取26例宫颈癌病例作为测试病例,自编程序实现OVH数据至图像转化及图像相似度计算。选取图像相似度最高的数据库病例的计划优化函数,结合Pinnacle3计划系统脚本实现自动计划设计。比较自动计划和手工计划的剂量学参数、计划质量和设计时间。结果与手工计划相比,自动计划的靶区覆盖、适形性、均匀性相当(P>0.05);直肠V40、V45和平均剂量分别下降了6.1%、1.3%和50.7 cGy(P<0.05),小肠和股骨头的平均剂量分别下降了31.7 cGy和188.9 cGy(P<0.05),髂骨的平均剂量下降了92.3 cGy(P>0.05)。自动计划降低了71%的计划设计时间。结论基于OVH和优质宫颈癌IMRT计划数据库所设计的宫颈癌自动调强计划,不仅大大减少了计划设计时间,而且能够在不降低靶区覆盖度、适形性的同时降低正常组织的受照剂量。Objective To develop and evaluate an automatic intensity-modulated radiation therapy(IMRT)program for cervical cancer based on a database of overlap volume histogram(OVH)and high-quality cervical IMRT plans for previously-treated patients.Methods A database consisting of high-quality IMRT plans and OVHs from 200 cervical cancer patients was established.OVHs of another 26 cervical cancer patients were converted into gray level images to calculate the image similarity compared with those from the database.The planning optimization function of the patients from the database with the highest image similarity was selected and inherent Pinnacle3 scripts were utilized to automatically generate IMRT plan.Finally,the dosimetric parameters,plan quality and design time were statistically compared between the automatic and manual plans.Results The target coverage,conformity index and homogeneity index did not significantly differ between two plans(all P>0.05).The V40,V45 and mean dose for the rectum in the automatic plans were significantly decreased by 6.1%,1.3%and 50.7 cGy than those in the manual plans(all P<0.05).Compared with the manual plans,the mean dose for the intestine and femur in the automatic plans were significantly reduced by 31.7 cGy and 188.9 cGy(both P<0.05),whereas the mean dose for the ilium was slightly decreased by 92.3 cGy in the automatic plans(P>0.05).The plan design time was shortened by 71%in the automatic plans.Conclusions The automatic IMRT plans based on a database of OVH and high-quality IMRT plans can not only significantly shorten the plan design time,but also reduce the irradiated dose of normal tissues without compromising the target coverage and conformity index.

关 键 词：宫颈肿瘤/调强放射疗法 重叠体积直方图 自动计划 

分 类 号：R737[医药卫生—肿瘤] TP3[医药卫生—临床医学]