Monaco放疗计划系统控制点设定对中下段食管癌动态调强放射治疗计划剂量学的影响  

Effect of the setting of control point of Monaco radiotherapy planning system on dosimetry of dIMRT plan for esophageal cancer of middle and lower segment

作　　者：王浩 杨蕴一[2] 李毅[2] 丁绮 郭峰 巩延涛 陈根祥 车亚 任英红 Wang Hao;Yang Yunyi;Li Yi;Ding Qi;Guo Feng;Gong Yantao;Chen Genxiang;Che Ya;Ren Yinghong(The Third Ward Region of Radiation Oncology Department,Shangluo Central Hospital,Shangluo 726000,China;Department of Radiation Oncology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Pharmacy,Shangluo Central Hospital,Shangluo 726000,China)

机构地区：[1]商洛市中心医院肿瘤三病区,商洛726000 [2]西安交通大学第一附属医院肿瘤放疗科,西安710061 [3]商洛市中心医院药学部,商洛726000

出　　处：《中国医学装备》2024年第9期1-6,共6页China Medical Equipment

基　　金：陕西省自然科学基础研究计划面上项目(2020JM-396);商洛市科学技术局项目(2022-Y-0044)。

摘　　要：目的:研究Monaco放射治疗计划系统中控制点(CP)不同取值对中下段食管癌动态调强放疗(dIMRT)计划的剂量学影响。方法:选取2023年1-6月在商洛市中心医院接受动态调强放疗的13例中下段食管癌患者,在Monaco放疗计划系统中对每例患者分别以CP限值为10、20、30、40、50、60、80、130和200设计9组dIMRT计划,除CP参数外其他优化参数均保持不变,分析靶区和危及器官(OAR)肺部、心脏和脊髓的剂量差异。结果:随着CP限值的增大,靶区最大剂量即2%靶区体积的受照剂量(D_(2%))、平均剂量即50%靶区体积的受照剂量(D_(50%))和剂量均匀性指数(HI)呈先减小然后趋于平稳;靶区最小剂量即98%靶区体积的受照剂量(D_(98%))和靶区适形度指数(CI)呈先增大然后趋于平稳;OAR的各剂量指标差异均无统计学意义(P>0.05);肺部5、10、20、30Gy剂量的体积百分比(V_(5)、V_(10)、V_(20)、V_(30))变化范围分别为1.13%、0.75%、0.29%和0.19%,肺部平均剂量(V_(mean))最大偏差18.7 cGy;心脏V_(10)、V_(20)、V_(30)、V_(40)变化范围分别为2.2%、1.23%、1.39%和1.12%,心脏V_(mean)最大偏差63.85 cGy,脊髓D_(max)最大偏差70.78 cGy.9组计划实际控制点个数(CP_(s))、计划执行时间(DT)、计划复杂度机器跳数与实际控制点个数比值(MU/CP_(s))比较,差异具有统计学意义(F=2.857、25.145、135.467,P<0.05)。结论:在中下段食管癌dIMRT计划中,最大CP值设定为40~50,在满足靶区和OAR剂量的前提下能够减少计划的优化时间、子野数目和患者的治疗时间。Objective:To study the dosimetry effects of differently selected values of control point(CP)in Monaco radiotherapy planning system on dynamic intensity modulated radiation therapy(dIMRT)for esophageal cancer of middle and lower segment.Methods:Thirteen patients with esophageal cancer at middle and lower segment who received dIMRT in Shangluo Central Hospital from January to June 2023 were selected.In the Monaco radiotherapy planning system,nine groups of dIMRT plans were designed for each patient according to the 9 kinds of CP limit values(10,20,30,40,50,60,70,80 and 90).There were not changes in other optimized parameters except CP parameter.The differences of the dosimetry between target region and organs at risk(OAR)included lung,heart and spinal cord were analyzed.Results:With the increase of the CP limit value,the maximum dose of the target region which was radiation dose(D_(2%))of 2%volume of target region,the mean dose,which was radiation dose(D_(50%))of 50%volume of target region,and the homogeneity index(HI)appeared a trend of gradual stability after reduction,and the radiation dose(D_(98%))of 98%volume of target region which was the minimum dose of target region and the conformance index(CI)appeared a trend of gradual stability after increase.There was not significant in each dose indicator of OAR(P>0.05).The variation ranges of lung at 5,10,20,30 Gy dose(V_(5),V_(10),V_(20) and V_(30))were respectively 1.13%,0.75%,0.29%and 0.19%,and the maximum deviation of mean dose(Vmean)of lung was 18.7 cGy.The variation ranges of V10,V20,V30 and V40 in the heart were respectively 2.2%,1.23%,1.39%and 1.12%,and the maximum deviation of Vmean in the heart was 63.85 cGy,and the maximum deviation of Dmax in the spinal-cord was 70.78 cGy.There were statistically significant differences in the actual CP number(CPs),execution time(DT)of plan,and ratio value of machine unit(MU)of the complexity of plan to CPs(MU/CPs)among the plans of 9 groups(F=2.857,25.145,135.467,P<0.05),respectively.Conclusion:In the dIMRT plan of esoph

关 键 词：控制点(CP) 中下段食管癌 动态调强放射治疗计划(dIMRT) 剂量学 

分 类 号：R816.5[医药卫生—放射医学]