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使用光子和渐进分辨率算法优化的前列腺容积调强弧形放疗计划的剂量学和放射生物学比较

Dosimetric and radiobiological comparison of prostate VMAT plans optimized using the photon and progressive resolution algorithm.

作者信息

Chow James C L, Jiang Runqing, Xu Lu

机构信息

Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1X6, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON M5S 3E2, Canada.

Medical Physics Department, Grand River Regional Cancer Centre, Kitchener, ON N2G 1G3, Canada; Department of Physics, University of Waterloo, Waterloo, ON N2L 3G1, Canada.

出版信息

Med Dosim. 2020;45(1):14-18. doi: 10.1016/j.meddos.2019.04.004. Epub 2019 May 15.

Abstract

This study compared the dosimetric and radiobiological parameters of prostate volumetric modulated arc therapy (VMAT) plans using different prescriptions optimized by the photon optimization (PO) and progressive resolution optimization (PRO) algorithm. A total of 20 prostate patients were selected retrospectively and divided into 2 groups of VMAT plans using prescriptions of 60 Gy/20 fx and 79 Gy/38 fx. Inverse treatment planning optimized by the PO and PRO algorithm based on the dual-arc technique was carried out by the Eclipse treatment planning system. The maximum dose, minimum dose, mean dose, dose-volume points, and dose-volume indices of the targets and organs at risk (OAR) were calculated from the plans. In addition, radiobiological parameters such as tumor control probability (TCP), normal tissue complication probability (NTCP), and equivalent uniform dose (EUD) of the targets and OAR were determined based on their dose-volume histograms (DVHs). A paired Student's t-test was carried out to compare the difference between mean dose-volume points, radiobiological parameters, and dose-volume indices. Two-tailed p < 0.05 was defined as having statistical difference. For prostate VMAT plans optimized by the PO algorithm, equal or slightly larger mean dose and TCP of the PTV (1% for 60 Gy/20 fx and 0.2% for 78 Gy/39 fx) were found by comparing to the PRO. These were followed by finding the slightly larger conformity index (CI; 0.927 vs 0.895 and 0.910 vs 0.904), larger or equal homogeneity index (HI; 0.054 vs 0.052 and 0.058 vs 0.058), and smaller gradient index (GI; 1.366 vs 2.288 and 1.585 vs 1.742) of the PTV using plans optimized by the PO vs PRO using prescriptions of 60 Gy/20 fx and 78 Gy/39 fx. For the OAR, we found that the mean doses, NTCPs, and EUDs of the rectum, bladder, and femur were slightly larger for plans optimized by the PO algorithm compared to the PRO, though both optimization algorithms satisfied all the dose-volume criteria and objectives in the inverse planning. Both the PO and PRO algorithm can generate prostate VMAT plans fulfilling the required dose-volume criteria. It is concluded that plans optimized by the PO algorithm can produce prostate plan with very similar quality compared to PRO.

摘要

本研究比较了使用光子优化(PO)和渐进分辨率优化(PRO)算法优化的不同处方的前列腺容积调强弧形治疗(VMAT)计划的剂量学和放射生物学参数。回顾性选取了20例前列腺癌患者,分为两组VMAT计划,分别采用60 Gy/20次分割和79 Gy/38次分割的处方。由Eclipse治疗计划系统基于双弧技术通过PO和PRO算法进行逆向治疗计划。从计划中计算靶区和危及器官(OAR)的最大剂量、最小剂量、平均剂量、剂量体积点和剂量体积指数。此外,根据靶区和OAR的剂量体积直方图(DVH)确定放射生物学参数,如肿瘤控制概率(TCP)、正常组织并发症概率(NTCP)和等效均匀剂量(EUD)。进行配对t检验以比较平均剂量体积点、放射生物学参数和剂量体积指数之间的差异。双侧p<0.05被定义为具有统计学差异。对于通过PO算法优化的前列腺VMAT计划,与PRO相比,PTV的平均剂量和TCP相等或略大(60 Gy/20次分割时为1%,78 Gy/39次分割时为0.2%)。其次,使用60 Gy/20次分割和78 Gy/39次分割处方的PO优化计划发现PTV的适形指数(CI;分别为0.927对0.895和0.910对0.904)略大,均匀性指数(HI;分别为0.054对0.052和0.058对0.058)相等或更大,梯度指数(GI;分别为1.366对2.288和1.585对1.742)更小。对于OAR,我们发现与PRO相比,PO算法优化的计划中直肠、膀胱和股骨的平均剂量、NTCP和EUD略大,尽管两种优化算法在逆向计划中均满足所有剂量体积标准和目标。PO和PRO算法均可生成符合所需剂量体积标准的前列腺VMAT计划。结论是,与PRO相比,PO算法优化的计划可以产生质量非常相似的前列腺计划。

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