Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
School of Pharmacy, Chengdu Medical College, Xindu Avenue No. 783, Chengdu, 610500, Sichuan, China.
Clin Transl Oncol. 2023 Nov;25(11):3230-3240. doi: 10.1007/s12094-023-03196-4. Epub 2023 Apr 25.
To evaluate the quality of fully automated stereotactic body radiation therapy (SBRT) planning based on volumetric modulated arc therapy, which can reduce the reliance on historical plans and the experience of dosimetrists.
Fully automated re-planning was performed on twenty liver cancer patients, automated plans based on automated SBRT planning (ASP) program and manual plans were conducted and compared. One patient was randomly selected and evaluate the repeatability of ASP, ten automated and ten manual SBRT plans were generated based on the same initial optimization objectives. Then, ten SBRT plans were generated for another selected randomly patient with different initial optimization objectives to assess the reproducibility. All plans were clinically evaluated in a double-blinded manner by five experienced radiation oncologists.
Fully automated plans provided similar planning target volume dose coverage and statistically better organ at risk sparing compared to the manual plans. Notably, automated plans achieved significant dose reduction in spinal cord, stomach, kidney, duodenum, and colon, with a median dose of D reduction ranging from 0.64 to 2.85 Gy. R50% and D of ten rings for automated plans were significantly lower than those of manual plans. The average planning time for automated and manual plans was 59.8 ± 7.9 min vs. 127.1 ± 16.8 min (- 67.3 min).
Automated planning for SBRT, without relying on historical data, can generate comparable or even better plan quality for liver cancer compared with manual planning, along with better reproducibility, and less clinically planning time.
评估基于容积旋转调强放疗（VMAT）的全自动立体定向体部放疗（SBRT）计划的质量，该方法可减少对历史计划和剂量师经验的依赖。
对 20 例肝癌患者进行全自动重新计划，进行基于全自动 SBRT 计划（ASP）程序的自动计划和手动计划，并进行比较。随机选择 1 例患者评估 ASP 的可重复性，基于相同的初始优化目标生成 10 个自动和 10 个手动 SBRT 计划。然后，基于不同的初始优化目标为另一个随机选择的患者生成 10 个 SBRT 计划，以评估可再现性。所有计划均由 5 名经验丰富的放射肿瘤学家以双盲方式进行临床评估。
全自动计划提供了与手动计划相似的计划靶区剂量覆盖，并在统计学上更好地保护了危及器官。值得注意的是，全自动计划在脊髓、胃、肾、十二指肠和结肠实现了显著的剂量降低，D 降低中位数范围为 0.64 至 2.85 Gy。与手动计划相比，自动化计划的 R50%和 10 个环的 D 明显更低。自动化计划和手动计划的平均计划时间分别为 59.8±7.9 分钟和 127.1±16.8 分钟（减少 67.3 分钟）。
无需依赖历史数据的 SBRT 自动计划可以为肝癌生成与手动计划可比甚至更好的计划质量，具有更好的可再现性，并且临床计划时间更少。
