Auto-planning技术用于胸中段食管癌调强放疗的可行性  

Effect of Auto-planning Technology in Intension-modulated Radiotherapy for Mid-esophageal Cancer Patients

作　　者：徐晓捷 侯鹏 雷亚楠 张瑞英[1] 韩振坤[1] XU Xiao-jie;HOU Peng;LEI Ya-nan;ZHANG Rui-ying;HAN Zhen-kun(The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Luoyang,China,471003)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院,中国洛阳471003

出　　处：《食管疾病》2021年第3期189-193,共5页Journal of Esophageal Diseases

摘　　要：目的探讨Auto-planning技术用于食管癌调强放疗计划设计的可行性。方法选取24例食管癌放疗病例,用Pinnacle 3计划系统设计自动治疗计划(ap-IMRT)和人工计划(m-IMRT),比较两种不同计划的剂量体积直方图(DVH),用配对t检验分析靶区和危及器官受照剂量的差异。结果肿瘤靶区GTV的D_(min)(t=-2.233,P=0.036)、均匀性指数HI(t=2.205,P=0.038),计划靶区PTV的D 98(t=-2.241,P=0.035)、HI(t=2.543,P=0.018)、适形度指数CI(t=-2.497,P=0.020),左肺V 20(t=4.412,P=0.000)、V_(30)(t=5.243,P=0.000),心脏V 30(t=2.546,P=0.018)、V_(40)(t=2.404,P=0.025)、D_(mean)(t=2.565,P=0.017),以上参数均是ap-IMRT计划优于m-IMRT。脊髓最大受照剂量D_(max)(t=-1.891,P=0.045),m-IMRT计划优于ap-IMRT。结论ap-IMRT靶区剂量分布能够达到较好均匀性和适形度,且能更地保护并行器官,但对串行器官脊髓的保护欠佳。Objective To explore the feasibility of auto-planning in the design of intension-modulated Radiotherapy(IMRT)plans for Mid-esophageal Cancer Patients.Methods A total of 24 radiotherapy esophageal cancer patients were selected.The automatic treatment plan(ap-IMRT)and manual treatment plan(m-IMRT)were designed respectively by Pinnacle 3 treatment planning system.The dose volume histograms(DVH)of the two plans were compared and the dose difference between the target area and organs at risk was analyzed by paired t test.Results The ap-IMRT plan were significantly better than the m-IMRT in the target area terms of Dmin(t=-2.233,P=0.036)and uniformity index(HI)(t=2.205,P=0.038)of Gross tumor volume(GTV),D 98(t=-2.241,P=0.035),HI(t=2.543,P=0.018)and conformity index CI(t=-2.497,P=0.020)of planning target volume(PTV).The ap-IMRT plans were significantly better than the m-IMRT in the organs at risk terms of the left lung V_(20)(t=4.412,P=0.000)and V 30(t=5.243,P=0.000),heart V_(30)(t=2.546,P=0.018),V_(40)(t=2.404,P=0.025)and D_(mean)(t=2.565,P=0.017).The m-IMRT plans were significantly better than the ap-IMRT in the term of the maximum dose of spinal cord D_(max)(t=-1.891,P=0.045).Conclusion Compared with m-IMRT plans,the dose distribution of ap-IMRT target area can achieve better uniformity and conformity,and can better protect parallel organs,but the protection of serial organs spinal cord is not good enough.

关 键 词：自动计划 食管癌 调强放疗计划 剂量学 

分 类 号：R735.1[医药卫生—肿瘤]