DVH预测模型在VMAT计划培训中的应用  

Application of DVH prediction model in VMAT planning training

作　　者：王明理[1] 顾慧宽 胡江[1] 高兴旺 WANG Mingli;GU Huikuan;HU Jiang;GAO Xingwang(Department of Radiation Oncology,Sun Yat-sen University Cancer Center/State Key Laboratory of Oncology in South China/Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China;Department of Radiation Oncology,Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心放疗科/华南肿瘤学国家重点实验室/肿瘤医学协同创新中心,广东广州510060 [2]广东省人民医院/广东省医学科学院放疗科,广东广州510060

出　　处：《中国医学物理学杂志》2021年第8期925-929,共5页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(81371710);广东省科技计划项目(2013B021800149);广州市科技计划项目(201607010199)。

摘　　要：目的:以宫颈癌为例,探索使用剂量体积直方图(DVH)预测模型培训放疗物理师容积旋转调强(VMAT)计划设计的可行性及其效果。方法:随机选取20例宫颈癌测试病例对3名见习物理师进行两个阶段培训(第一阶段15例,第二阶段5例)。每位物理师分别采用两种方法设计VMAT计划:传统人工计划(MP)和基于DVH预测模型引导的自动计划(KBP)。对比不同阶段两种计划靶区和危及器官的各种剂量学参数,并做相应统计分析。结果:与人工计划相比,自动计划在明显提高PGTV靶区V_(60)覆盖(P<0.001),改善高剂量控制(V_(66))(P=0.027)的情况下,显著降低膀胱(P<0.001)、直肠(P<0.001)、左右肾(P=0.001和P<0.001)以及左右侧股骨头(P<0.001和P<0.001)等绝大部分正常组织器官的受照剂量。在提高计划合格率的同时,亦减小了计划者间的质量差异。结论:DVH预测模型有助于深化物理师对VMAT初始优化参数设置的理解,加快培训进度,提升VMAT计划设计水平。Objective To take cervical cancer as an example for exploring the feasibility and outcomes of using dose-volume histogram(DVH)prediction model to train the radiotherapy physicists for volumetric modulated arc therapy(VMAT)planning.Methods Twenty cervical cancer cases were randomly selected to carry out two stages of training(15 cases in the first stage and the other 5 cases in the second stage)for 3 trainee physicists.Each trainee physicist was required to design VMAT plan in two ways,obtaining manual plan(MP)and knowledge-based plan(KBP)which was planned based on DVH prediction model.The dosimetric parameters of target areas and organs-at-risk between two kinds of plans were compared and analyzed.Results Compared with MP,KBP significantly reduced the radiation doses delivered to the most of normal tissues such as bladder(P<0.001),rectum(P<0.001),left and right kidneys(P=0.001,P<0.001),and left and right femoral heads(P<0.001,P<0.001),while improving the V_(60) of PGTV(P<0.001)and enhancing high dose control(V_(66))(P=0.027).The KBP based on DVH prediction model not only increased the passing rate of VMAT plan,but also minimized interplanner diversity.Conclusion DVH prediction model helps to deepen the physicists'understanding on the setting of the initial optimization parameters of VMAT plan,speed up the training schedule and improve the VMAT planning skills.

关 键 词：宫颈癌 容积旋转调强 剂量体积直方图 预测模型 

分 类 号：R312[医药卫生—基础医学] R815.6