基于Pinnacle脚本构建宫颈癌调强放疗自动计划的研究  

Pinnacle script-based construction of automatic intensity-modulated radiotherapy plans for cervical cancer

作　　者：吴先想 蔡汉飞 曹露 李威 徐露 葛文洁 费振乐 Wu Xianxiang;Cai Hanfei;Cao Lu;Li Wei;Xu Lu;Ge Wenjie;Fei Zhenle(Department of Radiation Oncology,First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China;Department of Radiation Oncology,No.901 Hospital of PLA,Hefei 230031,China)

机构地区：[1]蚌埠医科大学第一附属医院放疗科,蚌埠233004 [2]解放军第901医院放疗科,合肥230031

出　　处：《中华放射医学与防护杂志》2024年第8期650-656,共7页Chinese Journal of Radiological Medicine and Protection

基　　金：蚌埠医学院自然科学重点项目课题(2020byzd160)。

摘　　要：目的探讨基于Pinnacle脚本构建宫颈癌调强放疗(IMRT)自动计划的可行性及其在宫颈癌计划设计中的优势。方法回顾性选取2020年1月至2022年8月于蚌埠医科大学第一附属医院放疗科接受宫颈癌IMRT病例共40例,其中25例作为目标函数初始化参考数据,在Pinnacle计划系统中设计自动计划脚本。对剩余15例病例分别进行自动计划与人工IMRT计划设计,比较两种计划设计用时,并通过剂量体积直方图对比靶区剂量学参数及危及器官受照剂量的差异。结果自动计划组比人工计划组设计用时平均减少32.81 min,差异有统计学意义(t=-12.91,P<0.05)。相较于人工计划组,自动计划组中靶区适形度指数提高了0.01,靶区均匀性指数降低0.02,其中靶区适形度指数的差异有统计学意义(t=-0.08,P<0.05)。自动计划组中膀胱的V_(40)、V_(45)和直肠的V_(40)、V_(45)分别平均降低了6.88%、4.12%、9.93%、12%,差异均有统计学意义(t=-4.49、-4.46、-3.62、-5.80,P<0.05)。两种计划中小肠的V30、V50及Dmax差异较小,其中V30和Dmax的差异均无统计学意义(P>0.05)。与人工计划组相比,自动计划组中双侧股骨头的V45和Dmean分别降低了7.9%、106.83 cGy,脊髓Dmax降低了100.14 cGy,差异均有统计学意义(t=-6.00、-2.52、-2.55,P<0.05)。结论基于Pinnacle脚本构建的宫颈癌调强放疗自动计划,在保证靶区剂量均匀性和适形度的同时,降低了危及器官受照射量,同时提高了计划设计效率。Objective To explore the feasibility of constructing automatic intensity-modulated radiotherapy(IMRT)plans for cervical cancer based on Pinnacle scripts and to assess the advantages of this method in designing treatment plans for cervical cancer.Methods A retrospective analysis was conducted for 40 cases of cervical cancer treated with IMRT in the department of radiation oncology of the First Affiliated Hospital of Bengbu Medical University.Among them,the data of 25 cases were employed as a reference for the initialization of objective functions.The scripts for automatic plans were designed in the Pinnacle planning system.For the remaining 15 cases,automatic and manual IMRT plans were designed(also referred to as the automatic planning group and the manual planning group,respectively).The design times of both groups were compared.Furthermore,both the dosimetric parameters of target volumes and the irradiation doses to organs at risk(OARs)were also compared between the two groups using dose-volume histograms.Results Compared to the manual planning group,the automatic planning group exhibited a statistically significant decrease in the average design time of 32.81 min(t=-12.91,P<0.05),a statistically significant increase in the conformity index of the target areas of 0.01(t=-0.08,P<0.05),and a decrease in the uniformity index of the target areas of 0.02.Compared to those of the manual planning group,the bladder's V_(40) and V_(45) and the rectum's V_(40) and V_(45) of the automatic planning group decreased by 6.88%,4.12%,9.93%,and 12%on average,respectively(t=-4.49,-4.46,-3.62,-5.80,P<0.05).Minimal differences were observed in the V30,V50,and Dmax of the small intestine between both groups,without statistically significant differences in V30 and Dmax(P>0.05).Compared to the manual planning group,the automatic planning group displayed decreases in the V45 and Dmeanof the bilateral femoral head of 7.9% and 106.83 cGy,respectively and a decrease in the spinal Dmax of 100.14 cGy,with statistically significant differenc

关 键 词：宫颈癌 自动计划设计 调强放射治疗 剂量学 

分 类 号：R737.33[医药卫生—肿瘤]