自动化计划设计在胸中上段食管癌调强放疗中的应用研究

Research on the Application of Automated Plan of Intensity Modulated Radiation Therapy for Middle and Upper Esophageal Cancer

目的比较自动化计划设计模块在胸中上段食管癌调强放疗(IMRT)中应用的可行性。方法通过Pinnacle3 v9.10治疗计划系统进行手工IMRT计划和自动计划设计。利用SPSS 22.0统计学软件分析两种计划的靶区和危及器官剂量学结果以及机器跳数(MU)、计划优化时间。结果自动计划和手动计划靶区均能满足临床要求,自动计划适形度指数(CI)优于手工计划,差异有统计学意义(P<0.05);D_(2)、D_(98)、和HI差异均无统计学意义(P>0.05)。危及器官方面,自动计划全肺的V_(5)、V_(15)、V_(20)、V_(30)、D_(mean)均小于手工计划,差异有统计学意义(P<0.05),而V_(10)、V_(40)差异无统计学意义(P=0.326,0.135)。心脏V_(30)、D_(mean)结果为自动计划小于手工计划,差异有统计学意义(P<0.05),而V_(40)差异无统计学意义(P=0.121)。此外,自动计划较手工计划MU减少约27.50%,计划优化时间减少约37.49%。结论食管癌自动化计划设计模块能提高计划质量,值得临床推广。

Objective To analyze the feasibility of the application of automated plan of intensity modulated radiation therapy for middle and upper esophageal cancer.Methods The manual IMRT plan and automatic plan design through Pinnacle3 v9.10 treatment planning system were designed.SPSS 22.0 statistical software were used to analyze the target volume and organs at risk of the two plans,the dosimetry results and the number of Monitor Units(MU),and plan optimization time.Results Both automatic planning and manual planning of target volume can meet clinical requirements.Automatic planning CI is better than manual planning,and the results are statistically significant(P<0.05);D2,D98,and HI are not significantly different(P>0.05).In terms of organs at risk,the V5,V15,V20,V30,and Dmean of the automatic plan for the whole lung were all smaller than those of the manual plan,and the results were significantly different(P<0.05),while the results of V10 and V40 were not significantly different(P=0.326,0.135).The results of cardiac V30 and Dmean were that the automatic plan was smaller than the manual plan,and the results were significantly different(P<0.05),while the V40 results were not significantly different(P=0.121).In addition,the automatic plan is reduced by about 27.5%compared with the manual plan MU,and the planning optimization time is reduced by about 37.49%.Conclusion The automatic IMRT plan for esophageal cancer could improve the quality of the plan,which is worthwhile clinical application.