Meshram Mukesh N, Singh Laishram Amarjit, Palikundwar Umesh A
X-Ray Research Laboratory, Department of Physics, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, 440033, India.
Department of Radiation Oncology, National Cancer Institute, Nagpur, 441108, India.
Radiol Phys Technol. 2025 Sep;18(3):851-860. doi: 10.1007/s12194-025-00939-6. Epub 2025 Jul 14.
This study aims to compare and evaluate the potential benefits of using single DV-based, multiple DV-based physical cost function, and biological-based cost functions for organs at risk (OARs) sparing in IMRT as well as VMAT plans of head and neck cancer. Forty head and neck cancer patients treated with inverse plan optimization techniques were retrospectively enrolled for this study. Three different treatment plans were optimized by single DV-based, multiple DV-based physical cost functions, and biological-based cost functions on MONACO 6.1® TPS. All three optimized plans were normalized to deliver the same prescribed target dose. All 120 optimized plans were analyzed using dose evaluation parameters. For IMRT plans, the biological cost functions (BCF) were superior to both DV-based optimizations when it came to the mean dose of parallel organs. For VMAT plans, multiple DV-based physical cost function optimization resulted in a lower mean dose of parallel organs when compared with other two optimization. The biological cost function significantly reduced the mean dose of parallel organs, for which multiple DV-based cost functions were not used. In both IMRT and VMAT plans, the DV-based physical cost function significantly reduced the maximum dose of serial organs, with the exception of the mandible. Biological-based optimization made it more likely that the parallel OARs would be spared in IMRT plans, while multiple DV-based optimization made it more likely that the parallel OARs would be spared in VMAT plans. Both DV-based optimization in IMRT and VMAT plans effectively spared the maximum dose of the serial organ.
本研究旨在比较和评估在头颈部癌的调强放射治疗（IMRT）以及容积调强弧形治疗（VMAT）计划中，使用基于单一剂量体积（DV）、基于多个DV的物理代价函数和基于生物学的代价函数对危及器官（OARs）进行保护的潜在益处。本研究回顾性纳入了40例采用逆向计划优化技术治疗的头颈部癌患者。在MONACO 6.1®治疗计划系统上，通过基于单一DV、基于多个DV的物理代价函数和基于生物学的代价函数优化了三种不同的治疗计划。所有三种优化计划均进行归一化处理，以给予相同的处方靶剂量。使用剂量评估参数对所有120个优化计划进行分析。对于IMRT计划，在平行器官的平均剂量方面，基于生物学的代价函数（BCF）优于基于DV的两种优化方法。对于VMAT计划，与其他两种优化方法相比，基于多个DV的物理代价函数优化导致平行器官的平均剂量更低。在未使用基于多个DV的代价函数的情况下，基于生物学的代价函数显著降低了平行器官的平均剂量。在IMRT和VMAT计划中，基于DV的物理代价函数均显著降低了串行器官的最大剂量，但下颌骨除外。基于生物学的优化使得在IMRT计划中更有可能保护平行的OARs，而基于多个DV的优化使得在VMAT计划中更有可能保护平行的OARs。IMRT和VMAT计划中的基于DV的优化均有效地保护了串行器官的最大剂量。
