摘要
目的:比较3种基于Monaco计划系统的混合推量(hybrid boost,HB)计划设计方法在鼻咽癌放疗中的差异。方法:选取2021年1—12月于某院行鼻咽癌调强放疗(intensity-modulated radiotherapy,IMRT)的10例患者,对每例患者基于Monaco计划系统设计处方分次为33f的同步推量(simultaneous integrated boost,SIB)IMRT计划SIB-IMRT_(33f),保持分次剂量不变并将处方分次修改为28f得到SIB-IMRT_(28f)计划。基于SIB-IMRT_(28f)计划,分别通过利用Bias Plan功能,添加处方分次为5f的处方,复制SIB-IMRT_(33f)计划、修改处方分次为5f、删除PTV_(2)调强优化函数后重新优化3种方法设计SIB-IMRT_(5f1)、SIB-IMRT_(5f2)和SIB-IMRT_(5f3)计划,再将SIB-IMRT_(28f)计划与SIB-IMRT_(5f1)、SIB-IMRT_(5f2)和SIB-IMRT_(5f3)计划融合得到Plan_HB_(1)、Plan_HB_(2)和Plan_HB_(3)。比较3种HB计划的剂量学参数和治疗参数的差异,采用SPSS 20.0软件进行统计学分析。结果:3种HB计划的剂量分布均满足临床治疗要求,且Plan_HB_(2)大致等同于Plan_HB_(3)。Plan_HB_(2)和Plan_HB_(3)的计划肿瘤靶区(planning gross tumor volume,PGTV)和PTV1的D_(2%),PTV_(2)的D_(2%)、D_(mean)、均匀性指数和V_(PTV_(2),56)均劣于Plan_HB_(1),差异具有统计学意义(P<0.05);Plan_HB_(2)和Plan_HB_(3)的腮腺的D_(mean)、耳蜗的V55、口腔的D_(mean)、喉的D_(mean)和靶区外的V_(body-PTV),40与Plan_HB_(1)相比均增大,差异具有统计学意义(P<0.05);SIB-IMRT_(5f2)和SIB-IMRT_(5f3)计划的子野个数、机器跳数和出束时间与SIB-IMRT_(5f1)计划相比均减少,差异具有统计学意义(P<0.05)。结论:从计划设计方法角度分析,基于Monaco计划系统的3种HB计划设计方法在鼻咽癌放疗中均是可行的。从剂量学参数和治疗参数角度分析,Plan_HB_(2)大致等同于Plan_HB_(3),部分剂量学参数劣于Plan_HB_(1)但治疗参数优于Plan_HB_(1)。
Objective To analyze the differences of three design methods of hybrid boost(HB)plan based on Monaco in radiotherapy for nasopharyngeal carcinoma.Methods Ten patients who underwent intensity-modulated radiotherapy(IMRT)for nasopharyngeal carcinoma in some hospital from January to December 2021 were selected,and Monaco planning system was used to design a simultaneous integrated boost(SIB)IMRT plan SIB-IMRT_(33f) with a prescription fraction of 33f for each patient,keeping the fraction dose unchanged and modifying the prescription fraction to 28f to obtain a SIB-IMRT_(28f) plan.SIB-IMRT_(5f1),SIB-IMRT_(5f2) and SIB-IMRT_(5f3) plans were formed based on the SIB-IMRT_(28f) plan respectively by using the Bias Plan function,adding a prescription with a prescription fraction of 5f or copying the SIB-IMRT_(33f) plan,modifying the prescription fraction to 5f and executing re-optimization after deleting PTV_(2) optimization function,then Plan_HB_(1),Plan_HB_(2) and Plan_HB_(3) were got by fusing SIB-IMRT_(28f) with SIB-IMRT_(5f1),SIB-IMRT_(5f2) and SIB-IMRT_(5f3) plans.Differences in dosimetric and therapeutic parameters were compared among the three HB plans and statistically analyzed using SPSS 20.0 software.Results The dose distributions of the three HB plans all met clinical treatment requirements,and the dose distribution of Plan_HB_(2) was roughly equivalent to that of Plan_HB_(3).Plan_HB_(1) behaved better significantly than Plan_HB_(2) and Plan_HB_(3) in D_(2%)of planning gross tumor volume(PGTV)and PGTV1 target area and D_(2%),D_(mean),homogeneity index and V_(PTV_(2),56) of PTV_(2) target area(P<0.05);Plan_HB_(2) and Plan_HB_(3) both had D_(mean) of parotid gland,V55 of cochlea,D_(mean) of oral cavity,D_(mean) of larynx and V_(body-PTV) outside the target area increased significantly when compared with Plan_HB_(1) plan(P<0.05);SIB-IMRT_(5f2) and SIB-IMRT_(5f3) had the number of segments,number of monitor units and delivery time decreased when compared with SIB-IMRT_(5f1)(P<0.05).Conclusion All the three HB plan
作者
陈颖
刘茹佳
钟志鹏
喻刘杨
焦杨
许舒婷
CHEN Ying;LIU Ru-jia;ZHONG Zhi-peng;YU Liu-yang;JIAO Yang;XU Shu-ting(Cancer Center,Jingmen People's Hospital,Jingmen 448000,Hubei Province,China;Office of 323 Initiative,Jingmen People's Hospital,Jingmen 448000,Hubei Province,China)
出处
《医疗卫生装备》
CAS
2023年第11期50-55,共6页
Chinese Medical Equipment Journal
基金
荆门市一般科技计划项目(2023YFYB003)。
关键词
Monaco计划系统
同步推量
序贯推量
混合推量
鼻咽癌
调强放疗
Manaco planning system
simultaneous integrated boost
sequence boost
hybrid boost
nasopharyngeal carcinoma
intensity-modulated radiotherapy
