鼻咽癌调强放疗计划质量量化评价方法研究

Quantitative evaluation of the quality of intensity-modulated radiotherapy plan for nasopharyngeal carcinoma

目的:研究鼻咽癌放疗计划质量量化评价方法的可行性。方法:以RTOG 0615临床试验的剂量要求为基础,结合本中心临床需求设计鼻咽癌放疗计划质量的量化评估计算模型,计算每个计划的计划质量指数(PQI)。选取123例鼻咽癌放疗病例,通过调节临床计划的处方剂量(±3%)并计算其PQI,来评估量化评价方法对处方剂量变化的敏感性。同时根据已有的30例临床计划,将算法评价方法计算结果与临床医生的选择相比较,验证评价方法与临床医师决策的一致性。结果:+3%、-3%处方剂量和原治疗计划3组计划PQI分别为68.27±9.84、63.93±12.78、79.33±12.40,组间差异均有统计学意义(P<0.01);30例临床计划中,医师选择的计划的PQI为80.15±10.96,未被选择的计划PQI为74.78±9.41(P<0.01),量化评价算法与临床医生选择结果一致性为83.3%。结论:量化的计划质量评价方法对处方剂量较敏感,与临床医生选择有较高一致性,可以用于临床计划质量的评价。

Objective To study the feasibility of a method for quantitatively evaluating the quality of radiotherapy plan for nasopharyngeal carcinoma.Methods Based on the dose requirements of the RTOG 0615 clinical trial and the combination with clinical needs of Sun Yat-sen University Cancer Center,a model for quantitatively evaluating the quality of radiotherapy plans for nasopharyngeal carcinoma was designed,and the plan quality index(PQI)of each plan was calculated.A total of 123 cases of nasopharyngeal carcinoma treated with radiotherapy were analyzed in the study.The sensitivity of the quantitative evaluation method to the prescription dose change was evaluated by adjusting the prescribed dose(±3%)of clinical plan and calculating PQI.Meanwhile,according to the existing 30 clinical plans,the calculation results obtained by the proposed evaluation method were compared with the plans selected by clinicians to verify the consistency of the evaluation method and the clinician's decision.Results The PQI of 3 groups of plans,namely+3%prescribed dose,-3%prescribed dose and the original treatment plan,were 68.27±9.84,63.93±12.78,79.33±12.40,respectively;and the differences between these groups were statistically significant(P<0.01).For the 30 clinical plans,the PQI of the plans selected by physicians was 80.15±10.96,while that of the unselected plans was 74.78±9.41(P<0.01).The consistency between the results of the evaluation algorithm and the plan selected by clinicians was 83.3%.Conclusion The proposed method can be used for the quantitative evaluation of the clinical plan quality for it is sensitive to the prescribed dose and has high consistency with the selection made by clinicians.