基于Mobius 3D的舌癌IMRT计划的初步应用与探讨  

Preliminary Application and Discussion of Mobius 3D in Intensity-Modulated Radiotherapy(IMRT)Plan for Tongue Cancer

作　　者：毕帆 石慧烽[1,2] 胡海生 涂文勇[1,2] BI Fan;SHI Huifeng;HU Haisheng;TU Wenyong(Department of Oromaxillofacial Head and Neck Oncology,The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;National Clinical Research Center for Oral Disease,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海200011 [2]国家口腔疾病临床医学研究中心,上海200011

出　　处：《中国医疗设备》2023年第8期53-57,111,共6页China Medical Devices

基　　金：上海市黄浦区技术转移项目(XK2020012)。

摘　　要：目的 研究独立三维剂量验证系统Mobius 3D在舌癌放疗调强适形放射治疗(Intensity-Modulated Radiation Therapy,IMRT)计划中二次验算的可行性。方法 随机选取上海交通大学医学院附属第九人民医院在2021年1—12月收治的50例舌癌放疗患者的定位CT图像,分别在Monaco 5.11和Eclipse1 5.5计划系统进行9野等分IMRT计划设计,计划达到临床要求后分别将计划传入Mobius 3D中进行剂量二次验算。统计两种计划系统在传输过程中靶区和危及器官的体积变化和剂量差异,二次验算剂量前后行非参数Wilcoxon秩和检验,并使用γ通过率综合评估计划,验证三维剂量验证系统应用的可行性。结果 Monaco传输至Mobius中各感兴趣区域(Region of Interest,ROI)体积差异均小于Eclipse,最大变化差异ROI均为左腮腺(0.7%和1.34%)。经二次验算,两种计划系统的靶区和剂量差异均在0.6%内,但Eclipse计划系统二次验算剂量结果差异大于Monaco计划系统。Monaco计划系统与Mobius 3D二次验算后,计划靶区(Planning Target Volume,PTV54)的Dmean验算前后差异有统计学意义(P<0.05);Eclipse计划系统与Mobius 3D二次验算后,PTV60、左腮腺和右腮腺的Dmean在验算前后差异有统计学意义(P<0.05)。各结构和计划的γ通过率均值均大于97%,在整体计划γ通过率中,Monaco的通过率略高于Eclipse。结论 使用独立三维剂量验证Mobius 3D系统对舌癌IMRT计划进行二次验算具有可行性,结果准确清晰,使用简便,可将该系统作为计划二次核查使用,提高调强计划剂量验证的效率与准确性。Objective To study the feasibility of the independent three-dimensional dose verification system Mobius 3D in the second verification of intensity-modulated radiation therapy(IMRT)planning for tongue cancer.Methods The positioning CT images of 50 patients with tongue cancer treated in the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2021 were randomly selected,and the nine field equal division IMRT plan design was carried out in the Monaco 5.11 and Eclipse15.5 planning systems,respectively.After the plan met the clinical requirements,the plan was transferred to Mobius 3D for the second dose verification.The volume changes and dose differences between the target area and organs at risk during the transmission process of the two planning systems were calculated,non parametric Wilcoxon rank sum test was performed before and after the second checking dose.The feasibility of the application of the three-dimensional dose verification system was verified by using theγpass rate comprehensive evaluation plan.Results The volume difference of each region of interest(ROI)transferred from Monaco to Mobius was smaller than that of Eclipse,and the largest change difference ROI was the left parotid gland(0.7%and 1.34%).After the secondary verification of the Monaco planning system and Mobius 3D,there was statistically significant difference in the Dmean of the planning target volume(PTV54)between before and after verification(P<0.05).After the Eclipse planning system and Mobius 3D secondary verification,there were statistically significant differences in Dmean of PTV60,left parotid gland and right parotid gland between before and after verification(P<0.05).The averageγpass rate of each structure and plan was greater than 97%.In the overall planγpass rate,Monaco was slightly higher than Eclipse.Conclusion It is feasible to use the independent three-dimensional dose verification Mobius 3D system to perform the second verification of the tongue cancer IMRT plan

关 键 词：调强适形放疗 三维剂量验证 Mobius 3D 二次验算 γ通过率 

分 类 号：R144[医药卫生—公共卫生与预防医学] R737.9