Hoffmann Matthew, Pacey Jacqueline, Goodworth Josie, Laszcyzk Andrea, Ford Richard, Chick Brendon, Greenham Stuart, Westhuyzen Justin
Department of Radiation Oncology, Mid-North Coast Cancer Institute, Port Macquarie, New South Wales, Australia.
Department of Radiation Oncology, Mid-North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia.
Rep Pract Oncol Radiother. 2019 Jan-Feb;24(1):92-96. doi: 10.1016/j.rpor.2018.10.009. Epub 2018 Nov 22.
To assess a class solution template for volumetric-modulated arc therapy (VMAT) for prostate cancer using plan analysis software.
VMAT is a development of intensity-modulated radiotherapy (IMRT) with potential advantages for the delivery of radiotherapy (RT) in prostate cancer. Class solutions are increasingly used for facilitating RT planning. Plan analysis software provides an objective tool for evaluating class solutions.
The class solution for VMAT was based on the current static field IMRT template. The plans of 77 prostate cancer patients were evaluated using a set of in-house plan quality metrics (scores) (PlanIQ™, Sun Nuclear Corporation). The metrics compared the class solution for VMAT planning with the IMRT template and the delivered clinical plan (CP). Eight metrics were associated with target coverage and ten with organs-at-risk (OAR). Individual metrics were summed and the combined scores were subjected to non-parametric analysis. The low-dose wash for both static IMRT and VMAT plans were evaluated using 40 Gy and 25 Gy isodose volumes.
VMAT plans were of equal or better quality than the IMRT template and CP for target coverage (combined score) and OAR combined score. The 40 Gy isodose volume was marginally higher with VMAT than IMRT (4.9%) but lower than CP (-6.6%)( = 0.0074). The 25 Gy volume was significantly lower with VMAT than both IMRT (-32.7%) and CP (-34.4%)( < 0.00001).
Automated VMAT planning for prostate cancer is feasible and the plans are equal to or better than the current IMRT class solution and the delivered clinical plan.
使用计划分析软件评估用于前列腺癌容积调强弧形放疗（VMAT）的类解决方案模板。
VMAT是调强放疗（IMRT）的一种发展形式，在前列腺癌放疗（RT）中具有潜在优势。类解决方案越来越多地用于促进放疗计划制定。计划分析软件为评估类解决方案提供了一个客观工具。
VMAT的类解决方案基于当前的静态野IMRT模板。使用一组内部计划质量指标（分数）（PlanIQ™，太阳核公司）评估77例前列腺癌患者的计划。这些指标将VMAT计划的类解决方案与IMRT模板和已交付的临床计划（CP）进行比较。八个指标与靶区覆盖相关，十个指标与危及器官（OAR）相关。对各个指标进行求和，并对综合分数进行非参数分析。使用40 Gy和25 Gy等剂量体积评估静态IMRT和VMAT计划的低剂量冲洗情况。
在靶区覆盖（综合分数）和OAR综合分数方面，VMAT计划的质量与IMRT模板和CP相当或更好。VMAT的40 Gy等剂量体积略高于IMRT（4.9%），但低于CP（-6.6%）（P = 0.0074）。VMAT的25 Gy体积显著低于IMRT（-32.7%）和CP（-34.4%）（P < 0.00001）。
前列腺癌的自动化VMAT计划是可行的，并且这些计划等同于或优于当前的IMRT类解决方案和已交付的临床计划。
