最小子野宽度对Ⅳ期非小细胞肺癌大分割容积旋转调强放射治疗计划质量的影响  

Influences of Minimum Segment Width on Plan Quality of Hypofractionated Volumetric Modulated Arc Therapy for StageⅣNon-Small Cell Lung Cancer

作　　者：魏鹏 王丽芳[2] 王梦雅 吕敏 刘卫东 杨君东[1] 叶书成[1,2] Wei Peng;Wang Lifang;Wang Mengya;Lv Min;Liu Weidong;Yang Jundong;Ye Shucheng(Department of Radiation Oncology,Affiliated Hospital of Jining Medical University,Jining Shandong272000,China;Department of Oncology,Affiliated Hospital of Jining Medical University,Jining Shandong272000,China;Clinical College,Jining Medical University,Jining Shandong 272067,China)

机构地区：[1]济宁医学院附属医院放疗科,山东济宁272000 [2]济宁医学院附属医院肿瘤科,山东济宁272000 [3]济宁医学院临床医学院,山东济宁272067

出　　处：《医疗装备》2021年第19期6-8,11,共4页Medical Equipment

基　　金：中华国际医学交流基金会肿瘤精准放疗星火计划临床科研基金(2019-N-11-22);吴阶平医学基金会临床科研专项基金(320.6750.19088-74);济宁医学院附属医院“苗圃”科研计划项目(MP-MS-2019-019)。

摘　　要：目的探讨Monaco治疗计划系统中3组不同最小子野宽度(MSW)对Ⅳ期非小细胞肺癌大分割容积旋转调强放射治疗(VMAT)计划质量的影响。方法随机选取2016年1月至2018年12月医院收治的12例Ⅳ期非小细胞肺癌患者,在相同优化条件下分别使用0.5、1.0、1.5 cm MSW进行大分割VMAT计划设计和评估,比较3组计划靶区的D2、Dmean、D98、适形度指数(CI)、均匀性指数(HI)、靶区覆盖率(TC)、危及器官(OARs)的受量、控制点数、机器跳数和计划验证通过率等指标。结果 3组计划的靶区D2和CI比较,差异无统计学意义(P>0.05);MSW1.0 cm、MSW1.5 cm计划的靶区Dmean、D98、TC均低于MSW0.5 cm计划,HI高于MSW0.5 cm计划,差异有统计学意义(P<0.05);MSW1.5 cm计划的靶区的D98、TC均低于MSW1.0 cm计划,HI高于MSW0.5 cm计划,差异有统计学意义(P<0.05)。MSW1.5 cm计划的双肺V20、Dmean和患侧肺V20、V12.5、V5、Dmean均低于MSW0.5 cm计划和MSW1.0 cm计划,差异有统计学意义(P<0.05);MSW1.0 cm计划与MSW1.5 cm计划的健侧肺V5、心脏Dmean均低于MSW0.5 cm计划,差异有统计学意义(P<0.05)。MSW1.0 cm计划和MSW1.5 cm计划的控制点数、机器跳数均低于MSW0.5 cm计划,且MSW1.5 cm计划的控制点数低于MSW1.0 cm计划,差异均有统计学意义(P<0.05);3组计划的验证通过率均>90%,但组间差异无统计学意义(P>0.05)。结论综合考虑计划的质量与执行效率,建议在Ⅳ期非小细胞肺癌大分割VMAT中采用1.0 cm作为MSW。Objective The influences of minimum segment width(MSW)on plan quality of hypofractioned volumetric modulated arc therapy(VMAT)for stageⅣnon-small cell lung cancer in three different Monaco therapy planning systems were explored.Methods A total of twelve patients with stageⅣnon-small cell lung cancer admitted to the hospital from January 2018 to December 2019 were selected and they were planned with different penalties on MSW of 0.5,1.0,and 1.5 cm under the same optimization conditions.The indexes of D2,Dmean,D98,conformity index(CI),homogeneity index(HI),target coverage(TC),dose volume of organs at risk(OARs),control points,monitor unit,and gamma pass rate of the plan verification were compared among the three set of plans.Results When D2 and CI were compared among the three set of plans,the differences were not statistically significant(P>0.05);The Dmean,D98 and TC of target volumes of MSW1.0 cm and MSW1.5 cm plans were both significantly lower than those of MSW0.5 cm plan,but HI were significantly higher than that of MSW0.5 cm plan(P<0.05);The D98 and TC of target volume of MSW1.5 cm plan were both significantly lower than those of MSW1.0 cm plan,and HI was significantly higher than that of MSW0.5 cm plan(P<0.05).The two-lung V20,Dmean and affected side lung V20,V12.5,V5 and Dmean of MSW1.5 cm plan were all significantly lower than those of MSW0.5 cm and MSW1.0 cm plans(P<0.05);The intact side lung V5 and heart Dmean of MSW1.0 cm and MSW1.5 cm plans were both significantly lower than those of MSW0.5 cm plan(P<0.05).The control points and monitor unit of MSW1.0 cm and MSW1.5 cm plans were both significantly lower than those of MSW0.5 plan,and the control points of MSW1.5 cm plan was significantly lower than that of MSW1.0 cm plan(P<0.05);The gamma pass rate of the plan verification of the three set of plans were all greater than 90%,but when they were compared,the difference was not statistically significant(P>0.05).Conclusion Taken plan quality and implement efficiency into account at the same time,hypofrac

关 键 词：最小子野宽度 非小细胞肺癌 容积旋转调强 计划质量 

分 类 号：R734.2[医药卫生—肿瘤]