摘要
目的比较Monaco计划系统计算网格大小对肺癌立体定向放射治疗(SBRT)计划质量的影响。方法回顾性选取2016-06-23-2018-10-23江门市中心医院20例单靶点肺癌患者的SBRT计划,在其他优化参数相同的情况下,对每例患者分别用1.5、2.0、2.5和3.0 mm计算网格设计4组SBRT计划,采用SPSS 23.0分析2.0、2.5和3.0 mm组与1.5 mm组剂量差异。结果2.0、2.5和3.0 mm组计划靶区最小量(D_(min))相较于1.5 mm组的偏差分别为(3.4±6.4)%(Z=-2.035,P=0.042)、(4.1±6.8)%(Z=-2.763,P=0.006)和(1.7±6.3)%(Z=-0.971,P=0.332),最大偏差达到25.9%。肺门最大剂量,2.0、2.5和3.0 mm组比1.5 mm组分别高8.2%、8.6%和12.0%,差异均有统计学意义,Z=-3.332,P=0.001;Z=-3.114,P=0.002;Z=-3.593,P<0.001。患侧肺V_(5 Gy)、V_(10 Gy)、V_(20 Gy),脊髓、胸壁和心脏最大剂量等不同计算网格下差异均<1%。1.5、2.0、2.5和3.0 mm组计划平均优化时间分别为(5597±2878)、(1866±810)、(832±366)和(555±241)s。结论在Monaco计划系统中不同计算网格(1.5~3.0 mm)对肺癌SBRT计划PTV最小剂量的影响差异有统计学意义,对靠近靶区危及器官的最大剂量也有影响。兼顾计划计算的准确性和计划设计的效率,推荐Monaco设计肺癌SBRT时采用2.0 mm计算网格。
Objective To compare the effect of dose calculation grid size on the plan quality of the lung stereotactic body radiation therapy in Monaco treatment planning system(TPS).Methods Total 20 lung cancer patients with single target treated in Jiangmen Central Hospital from Jan.23,2016 to Oct.23,2018 were retrospectively selected.For each patient,four groups of SBRT plans were designed by using 1.5,2.0,2.5 and 3.0 mm dose calculation grid size(GS),respectively,with the other optimization parameters and cost functions remaining unchanged.The difference of dosimetric parameters was evaluated by comparing the 2.0,2.5 and 3.0 mm GS plans with 1.5 mm group plans.Results Compared with the 1.5 mm group,the minimum dose of PTV(Dmin)deviations of the 2.0,2.5 and 3.0 mm groups were(3.4±6.4)%(Z=-2.035,P=0.042),(4.1±6.8)%(Z=-2.763,P=0.006),and(1.7±6.3)%(Z=-0.971,P=0.332),respectively,and the maximum deviation was 25.9%.There was no statistical difference of the other dose parameters between the groups,such as Dmax,Dmean,conformal index(CI),dose gradient R50%and maximum dose of 2.0 cm outside the target(D_(2 cm)).Relative to the 1.5 mm GS,maximum dose of in hilum increased by 8.2%,8.6%and 12.0%with the 2.0 mm GS,2.5 mm GS and 3.0 mm GS(Z=-3.332,P=0.001;Z=-3.114,P=0.002;Z=-3.593,P<0.001).For other OARs,the differences were less than 1%among the four group plans.The average optimization time of1.5 mm GS,2.0 mm GS,2.5 mm GS and 3.0 mm GS plans was(5597±2878),(1866±810),(832±366)and(555±241)s,respectively.Conclusions The dose grid size(1.5-3.0 mm)in the Monaco TPS has a statistical impact on the minimum dose of PTV for lung cancer SBRT plan,as well as the maximum dose of OAR close to the target area.Considering the accuracy of dose calculation and the efficiency of planning,2.0 mm dose grid size is recommended to be used when designing SBRT plans for lung cancer in Monaco TPS.
作者
王杰
陈利
肖林
张艳梅
WANG Jie;CHEN Li;XIAO Lin;ZHANG Yan-mei(Department of Radiation Oncology,Jiangmen Central Hospital,Jiangmen 529030,China;Department of Radiation Oncology,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China;Department of Radiotherapy,Hefei Ion Medical Center,Hefei 230088,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2021年第22期1749-1753,1760,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
国家自然科学基金面上项目(12075329)。
