鼻咽癌混合自动计划方案的临床实用性评估  

Evaluation of Clinical Practicability of Hybrid Automatic Treatment Planning for Nasopharyngeal Carcinoma

作　　者：莫恩伟 于蕾 彭冀优 杨龙 王佳舟[1] 胡伟刚[1] MO Enwei;YU Lei;PENG Jiyou;YANG Long;WANG Jiazhou;HU Weigang(Department of Radiation Oncology,Fudan University Shanghai Cancer Center,Shanghai,200032)

机构地区：[1]复旦大学附属肿瘤医院放射治疗中心,上海市200032

出　　处：《中国医疗器械杂志》2025年第1期55-60,共6页Chinese Journal of Medical Instrumentation

摘　　要：目的自动计划是目前常用的替代手动计划的方案之一。本研究通过比较自动计划与手动计划的结果,评估商用治疗计划系统的自动计划算法在鼻咽癌治疗方面的临床表现。方法该研究共纳入14名鼻咽癌患者,每位患者采用3套不同的临床目标分别生成3个基于3D剂量分布预测的混合自动计划和3个基于脚本的自动计划,与临床使用的手动计划相比较。结果基于3D剂量分布预测的混合自动计划在计划靶区体积(planning target volume,PTV)剂量覆盖上的表现与手动计划相当,在绝大多数危及器官的保护上能达到手动计划的水准,而基于脚本的自动计划在部分危及器官,尤其是在腮腺的保护上表现不佳。结论基于3D剂量分布预测的混合自动计划能够达到与手动计划相媲美的水准,并且在临床目标发生变化时,仍能保持良好的稳定性。Objective Automatic planning is a commonly used alternative to manual planning.This study evaluated the clinical performance of automatic plans available in commercial treatment planning systems for nasopharyngeal carcinoma(NPC)treatment by comparing automatic planning with manual planning.Methods A total of 14 patients with nasopharyngeal carcinoma were enrolled in the study.For each patient,three different sets of clinical goals were used to generate three hybrid automatic plans based on 3D dose distribution prediction and three automatic plans based on script,respectively,which were compared with the manual plans used in clinic.Results The dose coverage performance of the automatic planning based on 3D dose distribution prediction on the planning target volume(PTV)was comparable to that of the manual planning.Automatic planning based on 3D dose prediction achieved the level of manual planning in most organs at risk.However,automatic planning based on scripts did not perform well in the prediction of some organs at risk,especially the parotid gland.Conclusion The hybrid automatic plan based on 3D dose distribution prediction can reach the level of manual planning and have good robustness with the change of clinical objective.

关 键 词：自动计划 知识库计划 基于脚本的自动计划 鼻咽癌 

分 类 号：R312[医药卫生—基础医学]