Zhang Jun, Jiang Dazhen, Su Huanfan, Dai Zhitao, Dai Jing, Liu Hui, Xie Conghua, Yu Haijun
Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei 430072, People's Republic of China.
Jiangxi Medical College, Department of Medical Imaging, Shangrao, Jiangxi 334000, People's Republic of China.
Onco Targets Ther. 2019 Aug 12;12:6385-6391. doi: 10.2147/OTT.S201473. eCollection 2019.
The main aim of the study was to investigate the dosimetric difference between acuros XB algorithm (AXB), anisotropic analytic algorithm (AAA), and pencil beam convolution (PBC) algorithm in stereotactic body radiation therapy (SBRT) plan for non-small cell lung cancer (NSCLC).
Thirty-eight NSCLC patients were included. GTV, PTV, and organs at risk were delineated by the radiation oncologists. Three optimized SBRT plans for each patients were gained using three algorithms of AXB, AAA, and PBC with the identical plan parameters. Dosimetric endpoints were collected and compared among the three plans, including dosimetric criteria: V100%, V90%, PTV D, D, D, homogeneity index (HI), and Paddick conformity index (CI).
AXB plan resulted in decreased V100% with a mean difference 6.14% compared with PBC plan (For V100%, AXB vs AAA vs PBC=93.44% vs 95.54% vs 99.58%, <0.05). Three plans showed no significant difference as to the parameter V90%. AXB plan leaded to reduced D of PTV compared with other two algorithms (For D of PTV, AXB vs AAA vs PBC=4048cGy vs 4365Gy vs 4873Gy, <0.05). PBC induced the enhanced trend of D of PTV compared with other two algorithms (D among three algorithms, 0.05); and increased the D of PTV in three algorithms with significant difference (For D of PTV, AXB vs AAA vs PBC=5332cGy vs 5330Gy vs 5785Gy, <0.05). AXB algorithm achieved a similar plan conformity with other two algorithms (For CI, AXB vs AAA vs PBC=0.80 vs 0.85 vs 0.71, >0.05).
For SBRT plan of NSCLC, AAA and PBC algorithms overestimate target coverage, AXB algorithm is recommended for the SBRT plan of NSCLC.
本研究的主要目的是调查在非小细胞肺癌（NSCLC）的立体定向体部放射治疗（SBRT）计划中，Acuros XB算法（AXB）、各向异性分析算法（AAA）和笔形束卷积（PBC）算法之间的剂量学差异。
纳入38例NSCLC患者。由放射肿瘤学家勾画大体肿瘤体积（GTV）、计划靶体积（PTV）和危及器官。使用AXB、AAA和PBC三种算法，采用相同的计划参数，为每位患者获得三个优化的SBRT计划。收集并比较三个计划的剂量学终点，包括剂量学标准：V100%、V90%、PTV的Dmean、Dmax、Dmin、均匀性指数（HI）和帕迪克适形指数（CI）。
与PBC计划相比，AXB计划导致V100%降低，平均差异为6.14%（对于V100%，AXB vs AAA vs PBC = 93.44% vs 95.54% vs 99.58%，P < 0.05）。三个计划在参数V90%方面无显著差异。与其他两种算法相比，AXB计划导致PTV的Dmean降低（对于PTV的Dmean，AXB vs AAA vs PBC = 4048cGy vs 4365Gy vs 4873Gy，P < 0.05）。与其他两种算法相比，PBC导致PTV的Dmax有升高趋势（三种算法之间的Dmax，P = 0.05）；并且在三种算法中PTV的Dmin增加，差异有统计学意义（对于PTV的Dmin，AXB vs AAA vs PBC = 5332cGy vs 5330Gy vs 5785Gy，P < 0.05）。AXB算法与其他两种算法的计划适形性相似（对于CI，AXB vs AAA vs PBC = 0.80 vs 0.85 vs 0.71，P > 0.05）。
对于NSCLC的SBRT计划，AAA和PBC算法高估了靶区覆盖，NSCLC的SBRT计划推荐使用AXB算法。
