调强技术、治疗部位以及剂量体积算法对调强放疗计划三维剂量验证结果的影响研究  

Impacts of delivery techniques, treatment sites and dose-volume algorithms on results of three-dimensional dosimetric verification for intensity-modulated radiation therapy plans

作　　者：彭先成 刘晏明 鲁文力 张瀚尹 李英[2] 易鑫 PENG Xian-cheng;LIU Yan-ming;LU Wen-li;ZHANG Han-yin;LI Ying;YI Xin(The Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China;Department of Oncology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属永川医院,重庆402160 [2]重庆医科大学附属第一医院肿瘤科,重庆400016

出　　处：《医疗卫生装备》2024年第11期54-59,共6页Chinese Medical Equipment Journal

基　　金：重庆市自然科学基金项目(cstc2021jcyj-msxmX0138);重庆市科卫联合医学科研项目(2024MSXM104)。

摘　　要：目的:研究调强技术、治疗部位以及剂量体积算法对调强放疗(intensity-modulated radiation therapy,IMRT)计划三维剂量验证结果的影响,探究建立个体化放疗计划质量保证(quality assurance,QA)评估标准的重要性。方法:回顾性选取2017年1月—2022年2月在某院接受放疗的350例肿瘤患者IMRT计划的三维剂量验证结果,通过COMPASS系统进行数据采集,分别以不同调强技术(固定射束调强放疗、容积旋转调强放疗)、治疗部位(颈部、胸部和腹部)和剂量体积算法(各向异性解析算法和坍缩锥卷积算法)进行分组。比较各组3%/2 mm标准下的10%处方剂量区域的Gamma通过率(GP_(10%))、50%处方剂量区域的Gamma通过率(GP_(50%))和50%处方剂量区域的平均Gamma指数(μGI_(50%)),95%靶区体积的剂量D_(95%)、5%靶区体积的剂量D_(5%)和靶区平均剂量Dmean,头颈部放疗计划下腮腺的平均剂量D_(mean)、1%脊髓体积的剂量D_(1%)和1%脑干体积的剂量D_(1%),胸部放疗计划下肺、心脏的平均剂量D_(mean)和1%脊髓体积的剂量D_(1%),腹部放疗计划下膀胱、直肠和股骨头的平均剂量D_(mean)。采用SPSS 26.0软件进行统计学分析。结果:对于不同调强技术,除了腹部放疗计划的GP_(50%)之外,其余QA结果差异有统计学意义(P<0.05)。对于不同治疗部位,头颈部和腹部放疗计划、胸部和腹部放疗计划的QA结果差异有统计学意义(P<0.05),头颈部和胸部放疗计划的QA结果差异无统计学意义(P>0.05)。对于不同剂量体积算法,除了腹部放疗计划计划靶区(planning target volume,PTV)的D5%和胸部放疗计划PTV的D_(mean)和脊髓的D1%之外,其余的QA结果差异有统计学意义(P<0.05)。结论:剂量验证结果会因调强技术、治疗部位和剂量体积算法的不同而产生差异。当通用评估阈值不适用时,可考虑采用AAPM TG-218号报告所推荐的统计过程控制方法建立符合实际情况的放疗计划个性化QA评估标准。Objective To investigate the influence of different delivery techniques,treatment sites and dose-volume algorithms on the results of three-dimensional dosimetric verification for intensity-modulated radiation therapy(IMRT)plans and the importance of individualized quality assurance(QA)evaluation standard for radiotherapy plans.Methods Totally 350 tumor patients receiving radiotherapy at some hospital from January 2017 to February 2022 had their three-dimensional dosimetric verification results of IMRT plans selected retrospectively and underwent data collection with COMPASS system,and then were grouped in terms of delivery technique(fixed-beam IMRT and volumetric modulated arc therapy),treatment site(neck,chest and abdomen)and dose-volume algorithm(anisotropic analytical algorithm and collapsed cone convolution algorithm).All the groups were compared based on the 3%/2 mm criterion with regard to the Gamma pass rate of 10%prescription dose area(GP_(10%)),Gamma pass rate(GP_(50%))and mean Gamma index(μGI_(50%))of 50%prescription dose area,dose of 95%target volume(D_(95%))and its mean dose(D_(mean)),parotid gland mean dose(D_(mean)),dose of 1%spinal cord volume(D_(1%)),dose of 1%brain stem volume(D_(1%))of head and neck radiotherapy plan,heart and lung mean dose(D_(mean))and dose of 1%spinal cord volume(D_(1%))of chest radiotherapy plan and bladder,rectum and femur mean dose of abdomen radiotherapy plan(D_(mean)).SPSS 26.0 software was used for statistical analysis.Results For different delivery techniques,significant differences were found in all the QA results except GP_(50%)of abdomen radiotherapy plan(P<0.05).For different treatment sites,the differences were statistically significant between the QA results of head and neck radiotherapy plan and abdomen plan and between those of chest radiotherapy plan and abdomen radiotherapy plan(P<0.05),while were not significant between the QA results of head and neck radiotherapy plan and chest radiotherapy plan(P>0.05).For different dose-volume algorithms,the QA results h

关 键 词：调强技术 治疗部位 剂量体积算法 调强放疗计划 三维剂量验证 

分 类 号：R318[医药卫生—生物医学工程] R815[医药卫生—基础医学]