Compass三维剂量验证系统在非小细胞肺癌立体定向放射治疗中的应用

Application of Compass 3D dose validation system in SBRT of NSCLC

目的:探讨Compass验证系统在非小细胞肺癌(NSCLC)立体定向放射治疗(SBRT)三维剂量验证中的应用价值。方法:选取在医院就诊的12例NSCLC患者,在Monaco治疗计划系统上制定计划并将其传至Compass验证系统,对治疗计划系统计算的剂量分布(TC)与Compass验证系统独自计算的剂量分布(CC)和通过实测重建的剂量分布(RC)进行对比,TC与CC之间的比较为TC-CC组,TC与RC之间的比较为TC-RC组,分析各靶区和危及器官(OAR)的γ通过率和各器官靶区体积的受照剂量(D_(95)、D_(mean)、D_(5)、D_(max)、V_(20)、V_(10)、V_(5)等)参数差异。结果:TC-CC组靶区γ通过率>97%,TC-RC组靶区γ通过率<90%,TC-RC组的靶区γ通过率低于TC-CC组,差异有统计学意义(t=7.020,t=6.545;P<0.05)。TC-CC组平均剂量相对偏差为0.72%~1.50%,TC-RC组平均剂量相对偏差为2.84%~4.48%。所有OAR的γ通过率均>99%。两组之间双肺V_(12.5)与V_(10)、心脏D_(mean)、大血管D_(max)等指标比较差异均有统计学意义(t=3.316,t=5.390,t=-3.356,t=2.917;P<0.05)。结论:Compass三维验证系统的独立核算和实测重建可以全面的分析理论与实际照射剂量差异,为NSCLC患者SBRT计划的准确实施提供参考依据。

Objective:To explore the application value of Compass verification system in three-dimensional(3D)dose verification of stereotactic body radiation therapy(SBRT)for non-small cell lung cancer(NSCLC).Methods:12 NSCLC patients who admitted to hospital were selected.The treatment plan was formulated on Monaco treatment planning system,and then it was send to the Compass verification system.The dose distributions of treatment plan system calculation(TC),the Compass verification system with independent calculation(CC)and the measured Compass reconstruction calculation(RC)were compared.The comparison between TC and CC was TC-CC group,and that between TC and RC was TC-RC group.The Gamma pass rates of each target area and organ at risk(OAR),and the differences of parameters of exposure dose(D_(95),D_(mean),D_(5),D_(max),V_(20),V_(10),V_(5))of target region of each organ were analyzed.Results:The Gamma pass rate(<90%)of target region of TC-RC group was significantly lower than that(>97%)of TC-CC group(t=7.020,t=6.545,P<0.05).The range of relative deviation of the average dose of the TC-CC group was between 0.72% and 1.50%,and that of TC-RC group was between 2.84% and 4.48%.The gamma pass rates of all OAR were greater than 99%.The differences of V_(12.5) and V_(10) of whole lung,heart D_(mean) and aorta D_(max) between two groups were significant(t=3.316,t=5.390,t=-3.356,t=2.917,P<0.05).Conclusion:The independent accounting and measurement reconstruction of Compass 3 D verification system can comprehensively analyze the difference of exposure dose between theory and practice,and it can provide reference basis for the accuracy implementation of SBRT plan of NSCLC patients.