计划模板在调强放疗计划设计中的应用

An application of template in intensity modulated radiotherapy planning

目的探讨计划模板在调强放疗计划设计中的应用价值。方法在飞利浦Pinnacle 3R治疗计划系统平台上，以脚本记录方法记录调强计划设计过程并保存为计划模板（模板方式）。选择10例左侧乳腺癌保乳术后患者分别设计个体化调强计划（个体化方式）和模板方式对比两种计划所需时间、靶区适形指数和均匀性指数以及全肺接受〉30、20Gy照射体积V30、V20和心脏V30。结果模板方式和个体化方式的计划设计时间分别为（7．0±0．82）min和（36．5±6．84）min（t=13．55，P=0．000），靶区适形指数分别为0．851±0．015和0．845±0．032（t=0．59，P=0．560），均匀指数分别为（13．2±1．3）％和（14．4±1．6）％（t=1．804，P=0．08），全肺V30全肺V20、心脏V30分别为（8．80±0．53）％和（8．31±0．74）％（t=1．71，P=0．105）、（12．43±0．74）％和（12．61±0．94）％（t=0．48，P=0．638）、（9．89±1．14）％和（9．66±1．43）％（t=0．41，P=0．688）。结论对相同部位、分期、处方剂量的病种，应用计划模板能简化计划设计的操作步骤并缩短计划设计时间，值得推广应用。

Objective To study the application of template in intensity modulated radiotherapy （IMRT） planning. Methods With Philips Pinnacle. version 7.6e treatment planning system （TPS） platform, a template for left breast cancer＇s IMRT planning was customized by using the function of scripting. Ten patients received IMRT alone after breast-conserving surgery were selected, two IMRT plans were designed for each patient： individual plan and the plan based on the template. Dose parameters of target, including conformal index （CI） and homogeneity index （HI）, dose-volume histogram parameters, including V30, V20 of lung and cardiac, and the planning time were compared respectively. Results Of the two IMRT plans based on the template method and individual method, The average time of design an IMRT plan were 7 ± 0. 82 rain and 36.5 ± 6. 84 min （ t = 13.55, P = 0. 000）, the PTV average CI were 0. 851 ± 0. 015 and 0. 845 ± 0. 032 （ t = 0. 59,P = 0. 560）, the PTV average HI were （ 13.2 ± 1.3 ） % and （ 14.4 ± 1.6）%（t=1.804,P=0.8）,the lung average V30 were （8.80±0.53）% and （8.31±0.74）% （t= 1.71,P=0. 105） ,the lung V20 were （12.43±0.74）% and （12.61 ±0.94）% （t=0. 48,P=0. 638） ,the cardiac averageV30 were （9.89±1.14）% and （9.66±1.43）%（t=0.41,P=0.688）. Conclusion For the tumor with the same location and stage, the application of template can simplify planning process and reduce working time, which was worthy of expansion.