Department of Radiation Oncology, University of Pittsburgh Medical Center Cancer Centers, Pittsburgh, Pennsylvania.
Cleveland Clinic at Akron General, Akron, Ohio.
Pract Radiat Oncol. 2020 Mar-Apr;10(2):e103-e110. doi: 10.1016/j.prro.2019.08.008. Epub 2019 Aug 31.
To compare the doses calculated by the Analytical Anisotropic Algorithm (AAA), Acuros dose-to-medium, and Acuros dose-to-water for the patients with lung cancer treated at our institution and show that further investigation and clarification are needed about what dose specifications should be used for NRG clinical trials.
Twenty-one patients with lung cancer who previously received intensity modulated radiation therapy or volumetric modulated arc therapy-based treatments at our institution were analyzed by recalculating their plans for each one with the AAA algorithm (reviewed and approved by our radiation oncologists) and with both reporting modes of the Acuros algorithm. All plans used the same monitor units as the original approved plan and a 2.5-mm grid size. For each patient, D of clinical target volume (CTV) and CTV coverage ratios in each plan were compared, and dose distributions and dose-volume histograms calculated by AAA, Acuros dose-to-water (D), and Acuros dose-to-medium (D) were compared as well.
Differences between CTV D calculated by AAA and Acuros D were larger than the differences between AAA and Acuros XB D for all patients. When D of CTV was evaluated, the largest difference between AAA and Acuros D was 14.12% and between AAA and Acuros XB D was 3.68%. The average differences between the CTV D calculated by AAA and Acuros D was 5.39%. Coverage ratio between Acuros D and AAA ranges from 51.08% to 100% with an average of 91.32%; coverage ratio between Acuros D and AAA ranges from 87.2% to 100.41% with average of 98.94%; coverage ratio between Acuros D and Acuros D ranges from 58.58% to 100% with an average of 92.03%.
The present study shows large and systematic differences in doses calculated by AAA and Acuros D. Therefore, further investigation and clarification are needed about which dose reporting mode should be used.
比较分析各向异性分析算法（AAA）、Acuros 剂量到介质和 Acuros 剂量到水在我院治疗的肺癌患者中的剂量计算，并表明需要进一步研究和澄清 NRG 临床试验应使用何种剂量规范。
对我院 21 例接受调强放疗或容积调强弧形治疗的肺癌患者进行分析，用 AAA 算法（经我院放射肿瘤学家审核批准）和 Acuros 算法的两种报告模式重新计算他们的计划。所有计划均使用与原始批准计划相同的监测单位和 2.5mm 网格大小。对于每个患者，比较了每个计划中临床靶区（CTV）D 和 CTV 覆盖率比值，并比较了 AAA、Acuros 剂量到水（D）和 Acuros 剂量到介质（D）计算的剂量分布和剂量体积直方图。
对于所有患者，AAA 计算的 CTV D 与 Acuros D 的差异大于 AAA 与 Acuros XB D 的差异。当评估 CTV D 时，AAA 与 Acuros D 的最大差异为 14.12%，AAA 与 Acuros XB D 的最大差异为 3.68%。AAA 计算的 CTV D 与 Acuros D 的平均差异为 5.39%。Acuros D 与 AAA 的覆盖率比值在 51.08%至 100%之间，平均为 91.32%；Acuros D 与 AAA 的覆盖率比值在 87.2%至 100.41%之间，平均为 98.94%；Acuros D 与 Acuros D 的覆盖率比值在 58.58%至 100%之间，平均为 92.03%。
本研究表明 AAA 和 Acuros D 计算的剂量存在较大且系统的差异。因此，需要进一步研究和澄清应使用哪种剂量报告模式。
