Compass验证系统在乳腺癌保乳术后调强放射治疗计划验证中的应用及相关影响因素分析  

Application and analysis of related influencing factors of Compass verification system in breast cancer after breast conserving surgery intensity modulated radiation therapy plan verification

作　　者：郑倩倩 曹婧 曲荣荣 王子红 ZHENG Qian-qian;CAO Jing;QURong-rong;WANG Zi-hong(Department of Radiation Oncology,Capital Medical University Shijingshan Teaching Hospital,Beijing Shijingshan Hospital,Beijing 100043,China)

机构地区：[1]首都医科大学石景山教学医院,北京市石景山医院放疗科,北京100043

出　　处：《生物医学工程与临床》2024年第4期509-514,共6页Biomedical Engineering and Clinical Medicine

摘　　要：目的利用Compass三维验证系统对乳腺癌保乳术后调强放射治疗计划进行剂量验证,研究其影响因素并进行分类分析。方法选择乳腺癌保乳放射治疗女性患者20例,年龄45~74岁,中位年龄59岁;侧别,左侧10例,右侧10例。用Compass系统进行计划剂量验证,包括独立核算验证和实测重建剂量验证;将Monaco计划系统蒙卡算法计算的剂量(MCD)、Compass卷积/超分割算法独立核算剂量(CCD)和Compass实测重建剂量(CRD)三者之间两两剂量验证结果进行两两比较(CCD-MCD、CRD-CCD、CRD-MCD),比较参数包括靶区剂量最大限值10%生成区域的γ结果及剂量体积直方图(DVH)结果。结果CRD-MCD与CRD-CCD的γ通过率和平均γ值差异均有统计学意义[(95.23±2.38)%vs(96.33±2.72)%、(94.78±2.56)%vs(95.97±2.95)%、0.41±0.04 vs 0.37±0.04、0.42±0.04 vs 0.38±0.04。P<0.05],CRD-MCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(95.23±2.38)%vs(99.29±0.46)%、(94.78±2.56)%vs(99.26±0.46)%、0.41±0.04 vs 0.26±0.03、0.42±0.04 vs 0.27±0.03。P<0.05],CRD-CCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(96.33±2.72)%vs(99.29±0.46)%、(95.97±2.95)%vs(99.26±0.46)%、0.37±0.04 vs 0.26±0.03、0.38±0.04 vs 0.27±0.03。P<0.05]。计划肿瘤靶区(PGTV)的D_(98%)和计划靶区(PTV)的D_(mean)、健侧乳腺的D_(mean)、V5和患侧肺的V20、V30的剂量体积相对偏差在CRD-MCD与CRD-CCD比较,差异有统计学意义[(2.01±1.27)%vs(2.60±1.05)%、(2.84±0.55)%vs(2.55±0.71)%、(-11.15±7.87)%vs(-18.29±7.91)%、(-1.45±5.45)%vs(-2.76±3.83)%、(-0.85±0.36)%vs(-0.65±0.23)%、(-0.56±0.37)%vs(-0.38±0.27)%。P<0.05]。PGTV的D98%、D_(2%)、D_(mean),PTV的D_(98%)、D_(2%)、D_(mean),心脏的D_(mean)、健侧乳腺的D_(mean)、V_(5),健侧肺的V_(5)和患侧肺的V_(5)、V_(20)、V_(30)的剂量体积相对偏差在CRD-MCD与CCD-MCD比较,差异均有统计学意义[(2.01±1.27)%vs(-0.51±0.54)%、(2.86±1.22)%vs(-0.002±0.92)%、(2.63±0.7Objective To verify dose of intensity-modulated radiotherapy plan after breast conserving surgery for breast cancer by using Compass three-dimensional verification system, as well as study and classify the influencing factors. Methods A total of 20 female patients with breast cancer treated with breast conserving radiotherapy were enrolled, which aged 45-74years old with mean median age of 59 years old. There were 10 cases on the left and 10 cases on the right. The planned dose verification was performed with Compass system, which included independent accounting verification and measured reconstruction dose verification. The dose verification results of Monaco planning system Monte Carlo algorithm calculated dose(MCD),Compass convolution/super segmentation algorithm independent calculation dose(CCD) and Compass measured reconstruction dose(CRD) were compared in pairs(CCD-MCD, CRD-CCD, CRD-MCD), the parameters included γ results and dose volume histogram(DVH) results of the maximum dose limit of 10 % target volume. Results There were significant differences in γ-pass rate and mean γ value between CRD-MCD and CRD-CCD[(95.23 ± 2.38) % vs(96.33 ± 2.72) %,(94.78 ± 2.56) % vs(95.97 ±2.95) %, 0.41 ± 0.04 vs 0.37 ± 0.04, 0.42 ± 0.04 vs 0.38 ± 0.04. P < 0.05], there were statistically significant differences in γ-pass rate and mean γ value between CRD-MCD and CCD-MCD[(95.23 ± 2.38) % vs(99.29 ± 0.46) %,(94.78 ± 2.56) % vs(99.26 ± 0.46) %, 0.41 ± 0.04 vs 0.26 ± 0.03, 0.42 ± 0.04 vs 0.27 ± 0.03. P < 0.05], and there were statistically significant differences in γ-pass rate and mean γ value between CRD-CCD and CCD-MCD[(96.33 ± 2.72) % vs(99.29 ± 0.46) %,(95.97 ± 2.95) %vs(99.26 ± 0.46) %, 0.37 ± 0.04 vs 0.26 ± 0.03, 0.38 ± 0.04 vs 0.27 ± 0.03. P < 0.05]. The relative deviation of planning gross target volume(PGTV) D98 %and planning target volume(PTV) D_(mean), contralateral breast D_(mean), V5and ipsilateral lung V20, V30were statistically significant differences between CRD-MCD and CRD-CCD[(2.

关 键 词：COMPASS 乳腺癌保乳放疗 三维剂量验证 蒙卡算法 卷积/超分割算法 

分 类 号：R737.9[医药卫生—肿瘤]