基于PlanIQ的智能引导放射治疗计划设计在食管癌容积旋转调强中的可行性研究  

Research of volumetric modulated arc therapy plans of esophageal cancer based on intelligently guided radiotherapy plan design function of PlanIQ

作　　者：徐云 李自康 王奇峰[2] 王先良[2] 康盛伟[2] 吴骏翔 XU Yun;LI Zikang;WANG Qifeng;WANG Xianliang;KANG Shengwei;WU Junxiang(Department of Oncology,Ya'an People's Hospital,Sichuan University West China Hospital Ya'an Hospital,Ya'an,Sichuan625000,China;Radiotherapy Center,Sichuan Cancer Hospital,School of Medicine of University of Electronic Science and Technology of China,Chengdu,Sichuan 610041,China;Key Laboratory of Radiation Physics and Technology of Ministry of Education,Institute of Nuclear Science and Technology Sichuan University,Chengdu,Sichuan 610064,China)

机构地区：[1]四川大学华西医院雅安医院,雅安市人民医院肿瘤科,四川雅安625000 [2]四川省肿瘤医院,电子科技大学附属肿瘤医院放疗中心,四川成都610041 [3]四川大学原子核科学技术研究所,辐射物理及技术教育部重点实验室,四川成都610064

出　　处：《中华肿瘤防治杂志》2024年第23期1451-1458,共8页Chinese Journal of Cancer Prevention and Treatment

基　　金：四川省医学科研青年创新课题(Q16071);辐射物理及技术教育部重点实验室开放课题(2023SCUPT06);四川省肿瘤医院优秀青年基金(YB2023025)。

摘　　要：目的评估Pinnacle放射治疗计划系统中的PlanIQ可行性模块用于智能引导食管癌容积旋转调强放射治疗(VMAT)自动计划设计的可行性。方法回顾性收集2022-06-06-2023-06-28在四川省肿瘤医院接受VMAT的37例食管癌术后患者临床资料。选用Pinnacle 16.4.3计划系统,大体肿瘤计划靶区(PGTV)的处方剂量为60 Gy,2 Gy/次,共30次;计划临床靶区淋巴结(PCTVln)的处方剂量为54 Gy,2 Gy/次,共30次。使用Pinnacle系统中PlanIQ软件的剂量体积直方图(DVH)可行性模块重新设计2种自动VMAT计划,其中原手动VMAT计划为MP计划,根据DVH可行性为0.1时设计的自动VMAT计划为AP_(0.1)计划,DVH可行性为0.28设计的自动VMAT计划为AP_(0.28)计划。评估3种计划靶区和危及器官的剂量学参数、机器跳数和优化时间。AP_(0.1)计划和AP_(0.28)计划分别与MP计划比较,均采用配对t检验。结果AP_(0.1)计划质量优于MP计划和AP_(0.28)计划。对于靶区,AP_(0.1)计划PGTV的适形指数优于MP计划,t=3.531,P=0.001;对于危及器官,AP_(0.1)计划的心脏V_(30)、V_(40)和D_(mean),肺的V_(5)、V_(10)、V_(20)和D_(mean)均优于MP计划。AP_(0.1)计划的脊髓最大剂量相比MP计划降低了8.63 Gy,差异有统计学意义,t=2.934,P=0.006。此外,AP_(0.1)计划与MP计划相比,机器跳数差异无统计学意义(t=1.153,P=0.256),但计划优化时间平均少于MP计划20 min,t=0.547,P=0.032。结论使用PlanIQ中可行性为0.1时设计的自动计划在保证计划质量的同时提高了计划设计效率,具有临床可行性。另外,通过使用PlanIQ提供的优化条件可以减少计划优化时间,降低计划设计难度。Objective To assess the feasibility of the PlanIQ module in the Pinnacle treatment planning system(TPS)for intelligently guided volumetric modulated arc therapy(VMAT)in the treatment of esophageal cancer.Methods Clinical data of 37 postoperative esophageal cancer patients who received VMAT at Sichuan Cancer Hospital from June 6,2022,to June 28,2023,were retrospectively collected.The Pinnacle 16.4.3 planning system was used,with a prescription dose of 60 Gy for the target area plan gross tumor volume(PGTV),2 Gy per fraction,for a total of 30 fractions was 60Gy/30 fractions;the prescription dose for the plan clinical target volume lymph node(PCTV1n)was 54 Gy,2 Gy per fraction,for a total of 30 fractions.The dose-volume histogram(DVH)feasibility module of the PlanIQ software in the Pinnacle system was used to redesign two types of automatic VMAT plans,of which the original manual VMAT plan was the MP plan,the automatic VMAT plan designed based on a DVH feasibility of 0.1 was the AP_(0.1)plan,and the automatic VMAT plat designed based on a DVH feasibility of 0.28 was the AP_(0.28)plan.The dosimetric parameters of the target volumes,organs at risk(OAR),monitor unit,the optimization time among the three plans were evaluated.AP_(0.1)plan and AP_(0.28)plan were compared with the MP plan,and both used paired t-tests.Results The AP_(0.1)plan exhibited superior performance compared to both MP plan and AP_(0.28)plan.Concerning the target volume,the conformal index of PGTV in AP_(0.1)plan was superior to that of the MP plan(t=3.531,P=0.001).Concerning the OAR,the V_(30),V_(40)and D_(mean)of heart,V_9,V_(10),V_(20)and Dmean of the total lung in AP_(0.1)plan were superior than those of the MP plan.The maximum dose of spinal cord in AP_(0.1)plan decreased by 8.63 Gy compared to that of the MP plan,with a statistically significant difference(t=2.934,P=0.006).Moreover,there was no statistically significant difference in monitor units between the AP_(0.1)plan and MP plan(t=1.153,P=0.256).However,the plan optimization time was signi

关 键 词：PlanIQ 食管癌 容积旋转调强放射治疗 剂量学 PINNACLE 

分 类 号：R735.1[医药卫生—肿瘤]