无均整器的Halcyon平台下AXB与AAA算法在肺癌计划中剂量学差异及分析  

A comparative analysis of lung IMRT using Acuros XB and AAA calculation algorithms on Halcyon with flattening filter free

作　　者：李珍[1] 余建荣[1] 李民英[1] 杨鑫[2] LI Zhen;YU Jian-rong;LI Min-ying;YANG Xin(Department of Radiation Oncology,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,China;不详)

机构地区：[1]中山市人民医院肿瘤分院放疗科,广东中山528400 [2]中山大学肿瘤防治中心、华南肿瘤学国家重点实验室、肿瘤医学协同创新中心、广东省鼻咽癌诊治研究重点实验室,广东广州510060

出　　处：《广东医学》2022年第12期1507-1511,共5页Guangdong Medical Journal

基　　金：广东省基础与应用基础研究基金企业联合基金项目(2021A1515220140)。

摘　　要：目的分析无均整器的Halcyon平台下Acuros XB(AXB)算法与各向异性解析算法(anisotropic analytical algorithm,AAA)在肺癌IMRT计划中的剂量学差异。方法随机选取28例中央型肺癌病例,保持射野设置和MLC位置不变,分别采用AXB算法和AAA算法重新计算剂量得到两组IMRT计划,比较两种算法在IMRT计划的靶区、危及器官的剂量差异。对靶区统计:PTV的D_(98%)、V_(95)、V_(100)、V_(105)、D_(mean)、CI、HI、GI;对危及器官统计:双肺及健侧肺的V_(5)、V_(20)、V_(30)、D_(mean);心脏的V_(30)、D_(mean);食管的V_(60)、D_(mean);以及脊髓的D_(0.1cc)、D_(mean)。结果对于PTV,AXB算法的D_(98%)、D_(mean)、V_(100)均低于AAA算法(P<0.05);CI、HI、GI指标AXB算法略优于AAA(P<0.05)。对于健侧肺的V_(5)、D_(max)、D_(mean),心脏的V_(30),脊髓D_(0.1cc),AXB算法均优于AAA算法(P<0.05)。Halcyon平台AXB与AAA算法计划验证通过率分别为(99.0±1.67)与(98.5±1.84)(P=0.38)。结论无均整器模式下两种算法的IMRT计划均能满足临床要求,可以用于肺癌的IMRT计划设计。非均匀介质中AXB算法对危及器官的保护优于AAA算法,在肺癌调强放疗中可优先考虑AXB算法。Objective To compare the dosimetric impact of Acuros XB(AXB)on anisotropic analytical algorithm(AAA)for lung cancer treatment by intensity-modulated radiotherapy(IMRT)on Halcyon with flattening filter free.Methods Twenty-eight central lung cancer patients treated with IMRT were included.The plans were recalculated using AXB and AAA algorithm with the identical beam setup and multi-leaf collimator settings.The dosimetric indices of the target volume PTV and organs at risk(OARs),including D_(98%),V_(95),V_(100),V_(105),D_(mean),CI,HI,GIto PTV,V_(5),V_(20),and V_(30) to lungs;V_(30) and D_(mean) to heart;V_(60) and D_(mean) to esophagus;and D_(0.1cc) and D_(mean) to spinal cord;were used for comparison.Paired t-tests were used to analyze differences of means.Results AXB plan resulted in significant decreased D_(98%),D_(mean) and V_(100) to the PTV compared with AAA plan(P<0.05).AXB algorithm achieved a similar plan conformity with AAA.There were significant reductions observed in V_(5),D_(max) and D_(mean) to lungs;V_(30) to heart;and D_(0.1cc) to spinal cord for AXB algorithm as compared to AAA.The passing rate of QA verification for AXB and AAA algorithm were 99.0±1.67 and 98.5±1.84,respectively.Conclusion Both AXB and AAA plans with flattening filter free qualify the dosimetric requirements in clinical,all of them can apply in IMRT for lung cancer.The AXB IMRT plan could be used to benefit patients with lower dose for OARs in heterogeneous media.

关 键 词：Acuros XB算法 各向异性分析算法 肺癌 调强治疗 

分 类 号：R730[医药卫生—肿瘤] R811.1[医药卫生—临床医学]