基于Ethos自动计划的宫颈癌调强放疗与容积旋转调强放疗计划的剂量学比较  

Dosimetric Comparison of IMRT and VMAT Plans for Cervical Cancer Based on Ethos Auto Plan

作　　者：龙胜建 李超[2] 陈毅[2] 蔡嵘[2] 段隆焱[2] LONG Shengjian;LI Chao;CHEN Yi(Radiotherapy Room,Oncology Department,the Second Affiliated Hospital of Guizhou Medical University,Kaili City,Guizhou Province 556000;不详)

机构地区：[1]贵州医科大学第二附属医院肿瘤科放疗室,贵州省凯里市556000 [2]上海交通大学医学院附属瑞金医院放疗科

出　　处：《医学理论与实践》2025年第7期1098-1101,1105,共5页The Journal of Medical Theory and Practice

摘　　要：目的:研究基于人工智能优化引擎(IOE)的Ethos系统自带的Auto Plan计划:9野静态调强放疗(9F-IMRT)、12野静态调强放疗(12F-IMRT)以及3弧容积旋转调强放疗(3-VMAT)技术在宫颈癌放射治疗中的剂量学差异。方法:随机选取收治的宫颈癌患者20例,进行CT模拟定位,基于瓦里安Ethos系统的Auto Plan自动生成9F-IMRT、12F-IMRT以及3-VMAT计划,比较三种计划的靶区剂量适形度、均匀性和危及器官的剂量学差异,以及机器跳数(MU)。结果:9F-IMRT、12F-IMRT以及3-VMAT计划的靶区剂量均能够满足剂量学要求,12F-IMRT和3-VMAT计划靶区适形度的差异无统计学意义(P>0.05),9F-IMRT计划靶区适形度略差;9F-IMRT、12F-IMRT计划靶区均匀性更优,且与3-VMAT相比差异具有统计学意义(P<0.05)。危及器官保护方面,三种计划在膀胱、直肠、小肠、结肠、股骨头中最大剂量D_(max)具有显著性差异(P<0.05)。3-VMAT计划的MU低于9F-IMRT计划和12F-IMRT计划,差异具有统计学意义(P<0.05)。结论:对于宫颈癌患者,Ethos Auto Plan生成的9F-IMRT、12F-IMRT以及3-VMAT技术均可达到临床靶区剂量和危及器官的保护要求,但9F-IMRT、12F-IMRT计划在靶区均匀性方面优于3-VMAT计划;VMAT计划机器跳数明显低于IMRT计划,表明其治疗更高效。Objective:To investigate the dosimetric differences among 9-field static IMRT(9F-IMRT),12-field static IMRT(12F-IMRT),and 3-arc VMAT(3-VMAT)techniques for cervical cancerusing the artificial intelligence optimization engine(IOE).Methods:Twenty cervical cancer patients from our center were randomly selected for CT simulation.Based on the Varian Ethos system’s Auto Plan,9F-IMRT,12F-IMRT,and 3-VMAT plans were generated.The plans were compared with target dose conformity,homogeneity,organ-at-risk dosimetry,and monitor units(MU).Results:The target doses for all three plans met dosimetric requirements.There was no significant difference in target conformity between 12F-IMRT and 3-VMAT plans(P>0.05),while the 9F-IMRT plan showed slightly poorer conformity.Both 9F-IMRT and 12F-IMRT plans showed better target homogeneity than the 3-VMAT plans,with statistically significant differences(P<0.05).Significant differences in maximum dose(Dmax)for bladder,rectum,small intestine,colon,and femoral head were observed among the three plans(P<0.05).The MU for 3-VMAT was lower than that for 9F-IMRT and 12F-IMRT,with statistically significant differences(P<0.05).Conclusion:For cervical cancer patients,the 9F-IMRT,12F-IMRT,and 3-VMAT techniques generated by Ethos Auto Plan all meet the clinical requirements for target dose and organ at risk protection.However,the 9F-IMRT and 12F-IMRT plansprovide better target homogeneity than 3-VMAT;the VMAT plan has significantly lower MUs than the IMRT plans,indicating higher treatment efficiency.

关 键 词：自动计划 宫颈癌 调强放疗 容积旋转调强放疗 剂量学差异 

分 类 号：R737.33[医药卫生—肿瘤]