Monaco与Pinnacle计划系统在肺癌容积旋转调强计划中的比较

Comparison of Monaco and Pinnacle treatment planning systems in volumetric modulated arc therapy optimization for lung cancer

目的 比较Monaco和Pinnacle 2套计划系统设计的肺癌容积旋转调强（VMAT）计划的计划质量、治疗效率和剂量验证精度.方法 选取20例肺癌病例,其中左肺癌10例,右肺癌10例,分别利用Monaco 3.0和Pinnacle 9.2两套计划系统设计VMAT计划,比较2种计划的靶区适形度、均匀性、最大剂量（Dmax）、平均剂量（Dean）与最小剂量（Dmin）及危及器官的受照剂量;比较治疗计划执行时间、机器跳数和剂量验证的准确性.结果 除PTV的Dmin外,Monaco计划靶区的其他各项剂量学指标都明显优于Pinnacle（t=5.927 ～ 12.034,P＜0.05）;2种计划除患侧肺V10、全肺V5外,Monaco计划肺的其他剂量学指标都差于Pinnacle（t=3.545 ～7.485,P＜0.05）,Monaco计划对心脏的保护明显优于Pinnacle（=2.836 ～4.011,P＜0.05）,但较差的是Monaco计划执行时间（t=9.780,P＜0.05）和MU数量（t=5.304,P＜0.05）.Monaco计划的Delta4验证结果优于Pinnacle（t=4.937,P＜0.05）.结论 对于肺癌的VMAT计划,Monaco与Pinnacle两套计划系统都能满足临床应用要求;Pinnacle在肺的保护与计划执行方面有明显的优势,Monaco在靶区剂量分布和心脏的保护,以及剂量验证方面具有优势.

Objective To compare the performances of Monaco and Pinnacle treatment planning systems （TPS） for volumetric modulated arc therapy （VMAT） optimization regarding lung cancer.The TPS was compared in terms of dose distributions,treatment delivery parameters and quality control results.Methods For 20 patients,including 10 cases of left lung cancer and l0 cases of right lung cancer,two VMAT plans were generated for each case：one with Monaco 3.0 TPS and the other with Pinnacle 9.2 TPS.Two plans were compared among plan dosimetrie distribution.conformity index and homogeneity index of the targets,the average dose,maximum dose,minimum dose and interested dose volume histograms of organs at risk（OAR,and delivery time and MUs of the therapy plans,the accuracy of treatment plans dose verification.Results Monaco provided better PTV coverage than Pinnacle （t =5.927-12.034,P 〈 0.05） except Dminof PTV.Monaco had a worse sparing effect on lung than Pinnacle （t =3.545-7.485,P 〈0.05） except V10of diseased side lung and V5of total lung.In addition,Monaco had a better sparing effect on heart（t =2.836-4.011,P 〈0.05）.Monaco had fewer delivery time（t =9.780,P 〈0.05）and MUs（t =5.304,P 〈0.05）of the therapy plans,and the pass rate of QA was better than Pinnacle（t =4.937,P 〈 0.05）.Conclusions For lung cancer patients,VMAT treatment plans obtained with Monaco and Pinnacle could offer clinically acceptable dose distributions.Pinnacle might have a better sparing effect on lung and fewer delivery time and MUs of the therapy plans.Monaco had a better PTV coverage and heart sparing.Moreover,Monaco had better accuracy of treatment plans dose verification.