鼻咽癌調(diào)強(qiáng)放療計(jì)劃十分復(fù)雜, 計(jì)劃質(zhì)量通常與治療劑量師的經(jīng)驗(yàn)密切相關(guān)。本研究納入了10例不同分期的鼻咽癌患者, 基于Pinnacle3 9.2治療計(jì)劃系統(tǒng)腳本, 運(yùn)用計(jì)算機(jī)程序設(shè)置計(jì)劃的基本參數(shù)、目標(biāo)參數(shù)等, 最終自動(dòng)完成鼻咽癌調(diào)強(qiáng)放療計(jì)劃。然后, 對(duì)自動(dòng)和手動(dòng)調(diào)強(qiáng)放療計(jì)劃進(jìn)行統(tǒng)計(jì)學(xué)比較和臨床評(píng)估。結(jié)果顯示兩種計(jì)劃中大多數(shù)靶區(qū)和危及器官劑量學(xué)參數(shù)的差異無統(tǒng)計(jì)學(xué)意義。本文所述的鼻咽癌自動(dòng)調(diào)強(qiáng)放療計(jì)劃能夠滿足臨床放療要求, 顯著減少計(jì)劃時(shí)間, 同時(shí)避免因?yàn)榻?jīng)驗(yàn)不足等人為因素對(duì)計(jì)劃質(zhì)量造成的影響。
【摘要】 目的 研究Monaco治療計(jì)劃系統(tǒng)中不同參數(shù)設(shè)置對(duì)容積旋轉(zhuǎn)調(diào)強(qiáng)放射治療(VMAT)計(jì)劃質(zhì)量的影響，得出更合理的治療計(jì)劃參數(shù)設(shè)置以提高VMAT治療質(zhì)量?！》椒ā?010年1-5月間治療3例患者，為食管癌、宮頸癌和鼻咽癌各1例，分別設(shè)置不同的計(jì)劃參數(shù)進(jìn)行容積旋轉(zhuǎn)調(diào)強(qiáng)計(jì)劃優(yōu)化，通過多種評(píng)估指標(biāo)比較各VMAT計(jì)劃質(zhì)量的差異，得出臨床所需的MSC、MSS、SSF、Sm、MMS和MDR共6個(gè)治療計(jì)劃參數(shù)對(duì)VMAT治療質(zhì)量的影響?！〗Y(jié)果 MSC、MSS和SSF的3個(gè)參數(shù)對(duì)VMAT治療質(zhì)量不產(chǎn)生影響，有影響的Sm、MMS和MDR參數(shù)中，隨著Sm和MMS值的增大，VMAT計(jì)劃的劑量分布逐漸變差，但控制點(diǎn)數(shù)、機(jī)器跳數(shù)和照射時(shí)間均逐漸減小；隨著MDR值增大，VMAT治療的劑量分布先逐漸變差后不變，控制點(diǎn)數(shù)和機(jī)器跳數(shù)均是先增大后不變，而照射時(shí)間是先減小后不變。 結(jié)論 Sm、MMS和MDR 3個(gè)參數(shù)對(duì)VMAT計(jì)劃質(zhì)量有較大影響，對(duì)不同的患者，設(shè)置合適的Sm、MMS和MDR值對(duì)提高計(jì)劃質(zhì)量非常重要。【Abstract】 Objective To investigate the impacts of parameter settings on the quality of plans for the volumetric modulated arc therapy (VMAT) with Monaco treatment planning system. Methods Three patients who underwent VMAT from January to May 2010 were selected. The planning optimizations were processed by setting different planning parameters, including MSC, MSS, SSF, Sm, MMS and MDR, respectively. Then the quality of each plan with a certain set of parameters was evaluated by various evaluation indexes. The differences of quality among different plans were analyzed by comparing these indexes. Results There was no influence on the quality of VMAT planning for the parameter MSC, MSS and SSF to be set with different values. However, the other three parameters, MSC, MSS and SSF , affected the quality of VMAT planning with different values. Along with the aggrandizement of Sm and MMS value, the dose distribution of VMAT plans gradually became bad, while the number of control points, machine monitor units and irradiation time were gradually reduced. And along with the aggrandizement of MDR value, the dose distribution of VMAT plans became bad gradually until a constant state was reached, and both the number of control points and machine monitor units increased at first and then kept constant, while irradiation time decreased at first and then kept constant. Conclusion The selections of parameter Sm, MMS and MDR impact the quality of VMAT planning greatly. It is very important to set the suitable value of Sm, MMS and MDR to get the best planning quality for patients with different complexity.