Duan Yanhua, Zhong Shanshan, Feng Aihui, Kong Qing, Xu Zhiyong
Institute of Modern Physics, Fudan University, Shanghai, China.
Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Eur J Med Res. 2025 May 27;30(1):423. doi: 10.1186/s40001-025-02673-6.
The VenusX and Edge accelerators are two commercially available systems used for lung stereotactic body radiation therapy (SBRT) with Intensity-Modulated Radiation Therapy (IMRT) techniques.
A retrospective analysis was conducted on 40 lung cancer patients treated with the Edge accelerator. Treatment plans using both the Edge (Plan) and VenusX (Plan) accelerators were generated and evaluated using various dosimetric metrics, employing statistical analyses to identify significant differences.
For planned target volume (PTV), Plan outperformed Plan across the entire cohort, achieving a higher D2 dose (76.84 vs 75.56 Gy, p = 0.005), and showing significant improvements in conformity index (0.84 vs 0.80), homogeneity index (0.50 vs 0.47), and gradient index (5.12 vs 5.62), all with p < 0.001. Plan also recorded a lower D (27.27 vs 27.87 Gy, p = 0.004). Subgroup analyses revealed significant enhancements in conformity index (CI), homogeneity index (HI), and gradient index (GI) for both single and multi-target lesion patients, with multi-target also seeing a notably lower D. regarding organs at risk (OARs), Plan significantly reduced lung mean dose (D) (3.85 to 3.60 Gy), V (16.88% to 15.61%), and V (5.04% to 4.63%), along with improvements in the great vessels' D and max dose (D), and esophagus' D across all patients. Single-lesion patients saw consistent lung improvements, while multi-lesion patients experienced significant lung reductions and enhancements in great vessels' and esophagus' metrics.
In conclusion, both Plan and Plan achieved treatment plans that met the dosimetric criteria defined by the RTOG guidelines. While Plan exhibited improved values in CI, HI, and GI, these findings reflect observed dosimetric differences rather than definitive evidence of clinical superiority. Further prospective studies are warranted to evaluate the clinical relevance of these differences.
VenusX加速器和Edge加速器是两种可用于采用调强放射治疗（IMRT）技术的肺部立体定向体部放射治疗（SBRT）的商用系统。
对40例接受Edge加速器治疗的肺癌患者进行回顾性分析。使用Edge加速器（计划）和VenusX加速器（计划）生成治疗计划，并使用各种剂量学指标进行评估，采用统计分析来确定显著差异。
对于计划靶体积（PTV），在整个队列中计划优于计划，达到更高的D2剂量（76.84对75.56 Gy，p = 0.005），并在适形指数（0.84对0.80）、均匀性指数（0.50对0.47）和梯度指数（5.12对5.62）方面显示出显著改善，所有p值均<0.001。计划的D也较低（27.27对27.87 Gy，p = 0.004）。亚组分析显示，单靶病变和多靶病变患者的适形指数（CI）、均匀性指数（HI）和梯度指数（GI）均有显著提高，多靶病变患者的D也显著降低。关于危及器官（OARs），计划显著降低了肺平均剂量（D）（3.85至3.60 Gy）、V（16.88%至15.61%）和V（5.04%至4.63%），同时改善了所有患者大血管的D和最大剂量（D）以及食管的D。单病变患者的肺功能持续改善，而多病变患者的肺功能显著降低，大血管和食管指标得到改善。
总之，计划和计划均实现了符合RTOG指南定义的剂量学标准的治疗计划。虽然计划在CI、HI和GI方面表现出更好的值，但这些发现反映的是观察到的剂量学差异，而非临床优越性的确切证据。有必要进行进一步的前瞻性研究来评估这些差异的临床相关性。
