Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium; Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium.
Department of Radiotherapy-Oncology, Ghent University Hospital, Ghent, Belgium.
Int J Radiat Oncol Biol Phys. 2018 Oct 1;102(2):443-450. doi: 10.1016/j.ijrobp.2018.05.063. Epub 2018 Jun 2.
Automated planning aims to speed up treatment planning and improve plan quality. We compared manual planning with automated planning for lung stereotactic body radiation therapy based on dose-volume histogram statistics and clinical preference.
Manual and automated intensity modulated radiation therapy plans were generated for 56 patients by use of software developed in-house and Pinnacle 9.10 Auto-Planning, respectively. Optimization times were measured in 10 patients, and the impact of the automated plan (AP) on the total treatment cost was estimated. For the remaining 46 patients, each plan was checked against our clinical objectives, and a pair-wise dose-volume histogram comparison was performed. Three experienced radiation oncologists evaluated each plan and indicated their preference.
APs reduced the average optimization time by 77.3% but only affected the total treatment cost by 3.6%. Three APs and 0 manual plans failed our clinical objectives, and 13 APs and 9 manual plans showed a minor deviation. APs significantly reduced D (2% of the volume receives a dose of at least D2%) for the spinal cord, esophagus, heart, aorta, and main stem bronchus (P < .05) while preserving target coverage. The radiation oncologists found >75% of the APs clinically acceptable without any further fine-tuning.
APs may help to create satisfactory treatment plans quickly and effectively. Because critical appraisal by qualified professionals remains necessary, there is no such thing as "fully automated" planning yet.
自动化计划旨在加快治疗计划制定并提高计划质量。我们基于剂量-体积直方图统计数据和临床偏好，比较了肺立体定向体部放射治疗的手动计划和自动计划。
分别使用内部开发的软件和 Pinnacle 9.10 自动计划，为 56 名患者生成手动和自动调强放射治疗计划。在 10 名患者中测量了优化时间，并估计了自动计划 (AP) 对总治疗费用的影响。对于其余 46 名患者，根据我们的临床目标检查每个计划，并进行了剂量-体积直方图的两两比较。三位经验丰富的放射肿瘤学家评估了每个计划，并表示了他们的偏好。
AP 平均减少了 77.3%的优化时间，但仅影响了总治疗费用的 3.6%。有 3 个 AP 和 0 个手动计划未能满足我们的临床目标，有 13 个 AP 和 9 个手动计划仅存在轻微偏差。AP 显著降低了脊髓、食管、心脏、主动脉和主支气管的 D（体积的 2%接受至少 D2%的剂量）（P <.05），同时保持了靶区覆盖。放射肿瘤学家发现超过 75%的 AP 无需进一步微调即可临床接受。
AP 可以帮助快速有效地创建令人满意的治疗计划。由于仍然需要合格专业人员的严格审查，因此还不存在“全自动”计划。
Zotero 插件