Ueda Yoshihiro, Fukunaga Jun-Ichi, Kamima Tatsuya, Shimizu Yumiko, Kubo Kazuki, Doi Hiroshi, Monzen Hajime
Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 537-8567, Japan.
Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi- ku, Fukuoka, 812-8582, Japan.
Phys Eng Sci Med. 2023 Sep;46(3):1091-1100. doi: 10.1007/s13246-023-01278-9. Epub 2023 May 29.
To evaluate whether knowledge-based volumetric modulated arc therapy plans for prostate cancer with a multi-institution model (broad model) are clinically useful and effective as a standardization method.
A knowledge-based planning (KBP) model was trained with 561 prostate VMAT plans from five institutions with different contouring and planning policies. Five clinical plans at each institution were reoptimized with the broad and single institution model, and the dosimetric parameters and relationship between D and the overlapping volume (rectum or bladder and target) were compared.
The differences between the broad and single institution models in the dosimetric parameters for V, V, V, and D were: rectum; 9.5% ± 10.3%, 3.3% ± 1.5%, 1.7% ± 1.6%, and 3.6% ± 3.6%, (p < 0.001), bladder; 8.7% ± 12.8%, 1.5% ± 2.6%, 0.7% ± 2.4%, and 2.7% ± 4.6% (p < 0.02), respectively. The differences between the broad model and clinical plans were: rectum; 2.4% ± 4.6%, 1.7% ± 1.7%, 0.7% ± 2.4%, and 1.5% ± 2.0%, (p = 0.004, 0.015, 0.112, and 0.009) bladder; 2.9% ± 5.8%, 1.6% ± 1.9%, 0.9% ± 1.7%, and 1.1% ± 4.8%, (p < 0.018), respectively. Positive values indicate that the broad model has a lower value. Strong correlations were observed (p < 0.001) in the relationship between D and the rectal and bladder volume overlapping with the target in the broad model (R = 0.815 and 0.891, respectively). The broad model had the smallest R of the three plans.
KBP with the broad model is clinically effective and applicable as a standardization method at multiple institutions.
评估基于知识的容积调强弧形治疗计划在多机构模型（广义模型）下用于前列腺癌时作为一种标准化方法是否具有临床实用性和有效性。
使用来自五个机构的561个前列腺VMAT计划训练基于知识的计划（KBP）模型，这些机构具有不同的轮廓勾画和计划策略。每个机构的五个临床计划分别使用广义模型和单机构模型进行重新优化，并比较剂量学参数以及D与重叠体积（直肠或膀胱与靶区）之间的关系。
广义模型和单机构模型在V、V、V和D的剂量学参数方面的差异为：直肠，9.5%±10.3%、3.3%±1.5%、1.7%±1.6%和3.6%±3.6%，（p＜0.001）；膀胱，8.7%±12.8%、1.5%±2.6%、0.7%±2.4%和2.7%±4.6%（p＜0.02）。广义模型与临床计划之间的差异为：直肠，2.4%±4.6%、1.7%±1.7%、0.7%±2.4%和1.5%±2.0%，（p = 0.004、0.015、0.112和0.009）；膀胱，2.9%±5.8%、1.6%±1.9%、0.9%±1.7%和1.1%±4.8%，（p＜0.018）。正值表明广义模型的值较低。在广义模型中，观察到D与直肠和膀胱与靶区的重叠体积之间存在强相关性（p＜0.001）（R分别为0.815和0.891）。广义模型在三个计划中R最小。
广义模型的KBP作为一种标准化方法在多个机构中具有临床有效性和适用性。
