通量平滑度对非小细胞肺癌立体定向放射治疗中容积旋转调强治疗计划优化的影响研究  

Study on the effect of fluence smoothing on optimization of SBRT VMAT plan for non-small cell lung cancer

作　　者：刘子成 刘娜 刘苓苓[1,2,3] 费振乐[3,4,5] 牛振洋 崔相利 李洁 李兵兵[1,3] LIU Zi-cheng;LIU Na;LIU Ling-ling(不详;Anhui Province Key Laboratory of Medical Physics and Technology,Institute for Health and Medical Technology,Hefei Institute of Physical Science,Chinese Academy of Sciences.University of Science and Technology of China.Center of Radiotherapy,Hefei Cancer Hospital,Chinese Academy of Sciences.School of Biomedical Engineering,Anhui Medical University,Hefei 230032,China)

机构地区：[1]中国科学院合肥物质科学研究院健康与医学技术研究所医学物理与技术安徽省重点实验室,安徽合肥230031 [2]中国科学技术大学,安徽合肥230026 [3]中国科学院合肥肿瘤医院放疗中心,安徽合肥230031 [4]安徽医科大学生物医学工程学院,安徽合肥230032 [5]解放军联勤保障部队第901医院放疗科,安徽合肥230031

出　　处：《中国医学装备》2022年第7期11-16,共6页China Medical Equipment

基　　金：国家重点研发计划(2018YFE0114100)“多模态影像在恶性肿瘤质子精准治疗的关键技术和临床应用”;安徽省重点研究与开发计划(202004j07020052)“基于柔性压力传感器的智能床垫系统研发及其在放疗中的应用”;中国科学院合肥肿瘤医院优秀医学青年人才计划(2000000005)“呼吸运动对肺癌放疗位置和剂量的影响研究”。

摘　　要：目的:对比Monaco计划系统中旋转容积调强治疗(VMAT)计划的4种不同通量平滑度在非小细胞肺癌(NSCLC)患者体部立体定向放射治疗(SBRT)中的剂量学差异,分析探讨通量平滑度对计划优化的影响。方法:选取医院收治的13例周围型NSCLC患者的CT图像,所有计划保持优化函数与其他参数一致,分别使用通量平滑度关闭设置(Off)、低通量平滑度设置(Low)、Monaco 5.11.03计划系统中通量平滑度常规设置(Medium)和高通量平滑度设置(High)4种通量平滑度进行VMAT计划设计,并分别定义为Off组、Low组、Medium组和High组,比较4组不同计划的靶区、危及器官(OAR)的剂量学参数和机器跳数、计算时间和计划验证通过率。结果:High组与Medium组相比,机器跳数降低了6.0%,计算时间降低了5.0%,两组比较差异均有统计学意义(t=-2.642,t=-2.691;P<0.05)。High组与Medium组相比,肿瘤靶区的最大值和平均值、靶区覆盖率、靶区适形性指数(CI)、靶区均匀性指数(HI)、靶区剂量跌落指数(R50%)、计划验证通过率和正常组织的比较,差异均无统计学意义。结论:在NSCLC患者SBRT的VMAT计划设计中,应综合考虑计划质量和执行效率,选用高通量平滑度设计NSCLC患者SBRT的VMAT计划。Objective:To compare the dosimetric differences of four kinds of fluence smoothing of volumetric modulated arc therapy(VMAT)of Monaco planning system in stereotactic body radio therapy(SBRT)for patients with non-small cell lung cancer(NSCLC),and to analyze and explore the effect of fluence smoothing on optimization of plan.Methods:The CT images of 13 patients with peripheral NSCLC who admitted to hospital were selected,And all plans kept the consistence of optimal function with other parameters.And 4 kinds of fluence smoothing included the turnoff installation of fluence smoothing(Off),installation of low fluence smoothing(Low),the routine installation of fluence smoothing(Medium)in Monaco 5.11.03 plan system and the installation of high fluence smoothing(High)were used respectively to design VMAT plan,and they were defined as Off group,Low group,Medium group and High group.The dosimetry parameters and machine hop count of target volume and organ at risk(OAR),the calculation time and the passing rate of plan verification among 4 groups were compared.Results:The machine hop count of High group was 6.0%lower than that of Medium group,and calculation time of High group was 5.0%lower than that of Medium group,and the differences of them between two groups were significant(t=-2.642,t=-2.691,P<0.05).The differences of the maximum and average value of the target volume of tumor,the coverage rate of target volume,conformity index(CI)of target volume,homogeneity index(HI)of target volume,dose drop index of target volume(R50%),pass rate of plan verification and normal tissue between High group and Medium group were not significant.Conclusion:In the SBRT VMAT plan of patients with NSCLC,the plan quality and execution efficiency should be comprehensively considered,and the high fluence smoothing was selected to design the SBRT VMAT plan for patients with NSCLC.

关 键 词：通量平滑度 非小细胞肺癌(NSCLC) 立体定向放射治疗(SBRT) 容积调强治疗(VMAT) 

分 类 号：R815.6[医药卫生—放射医学] R734.2[医药卫生—临床医学]