Kumar Lalit, Bhushan Manindra, Kishore Vimal, Chowdhary Rahul Lal, Barik Soumitra, Sharma Anurag, Gairola Munish
Department of Applied Science and Humanities, Dr. A.P.J. Abdul Kalam Technical University, Lucknow, Uttar Pradesh, India.
Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
J Med Phys. 2022 Jan-Mar;47(1):10-19. doi: 10.4103/jmp.jmp_64_21. Epub 2022 Feb 18.
We aimed to evaluate the dosimetric influence of Acuros XB (AXB) dose-to-medium (D) and dose-to-water (D) reporting mode on carcinoma cervix using intensity-modulated radiation therapy (IMRT) and RapidArc (RA) technique.
A cohort of thirty patients cared for carcinoma cervix was retrospectively selected for the study. Plans were computed using analytical anisotropic algorithm (AAA), AXB-D, and AXB-D algorithms for dosimetric comparison. A paired -test and Pitman-Morgan dispersion test were executed to appraise the difference in mean values and the inter-patient variability of the differences.
The dose-volume parameters were higher for AXB-D in contrast to AAA for IMRT and RA plans, excluding D, minimum dose to planning target volume (PTV) and rectum mean dose (RA). There was no systematic trend observed in dose-volume parameters for PTV and organs at risk (OARs) between AXB-D and AXB-D for IMRT and RA plans. The dose-volume parameters for target were higher for AXB-D in comparison to AAA in IMRT and RA plans, except D and minimum dose to PTV. Analysis envisaged less inter-patient variability while switching from AAA to AXB-D in comparison to those switching from AAA to AXB-D.
The present study reveals the important difference between AAA, AXB-D, and AXB-D computations for cervix carcinoma using IMRT and RA techniques. The inter-patient variability and systematic difference in dose-volume parameters computed using AAA, AXB-D, and AXB-D algorithms present the possible impact on the dose prescription to PTV and their relative constraints to OARs for IMRT and RA techniques. This may help in the decision-making in clinic while switching from AAA to AXB (D or D) algorithm for cervix carcinoma using IMRT and RA techniques.
我们旨在评估Acuros XB（AXB）剂量至介质（D）和剂量至水（D）报告模式对采用调强放射治疗（IMRT）和容积旋转调强放疗（RA）技术治疗子宫颈癌的剂量学影响。
回顾性选取30例子宫颈癌患者进行研究。使用分析各向异性算法（AAA）、AXB-D和AXB-D算法计算计划以进行剂量学比较。执行配对t检验和皮特曼 - 摩根离散度检验以评估均值差异和患者间差异的变异性。
对于IMRT和RA计划，与AAA相比，AXB-D的剂量体积参数更高，但D、计划靶体积（PTV）的最小剂量和直肠平均剂量（RA）除外。对于IMRT和RA计划，在AXB-D和AXB-D之间，PTV和危及器官（OARs）的剂量体积参数未观察到系统趋势。与AAA相比，IMRT和RA计划中AXB-D的靶区剂量体积参数更高，但D和PTV的最小剂量除外。分析表明，与从AAA切换到AXB-D相比，从AAA切换到AXB-D时患者间变异性更小。
本研究揭示了使用IMRT和RA技术对子宫颈癌进行AAA、AXB-D和AXB-D计算之间的重要差异。使用AAA、AXB-D和AXB-D算法计算的剂量体积参数中的患者间变异性和系统差异，对IMRT和RA技术中PTV的剂量处方及其对OARs的相对限制可能产生影响。这可能有助于临床在使用IMRT和RA技术治疗子宫颈癌时从AAA切换到AXB（D或D）算法的决策。
