[1]周晖,张毅斌,陈佳艺,等.鲁棒性优化参数对局限期前列腺癌质子放疗剂量的影响[J].中国医学物理学杂志,2025,42(5):561-565.[doi:10.3969/j.issn.1005-202X.2025.05.001]
　ZHOU Hui,,et al.Effects of robust optimization parameters on radiation dose in proton radiotherapy for localized prostate cancer[J].Chinese Journal of Medical Physics,2025,42(5):561-565.[doi:10.3969/j.issn.1005-202X.2025.05.001]
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鲁棒性优化参数对局限期前列腺癌质子放疗剂量的影响()

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第5期
页码:
561-565
栏目:
医学放射物理
出版日期:
2025-05-20

文章信息/Info

Title:
Effects of robust optimization parameters on radiation dose in proton radiotherapy for localized prostate cancer
文章编号:
1005-202X（2025）05-0561-05
作者:
周晖1; 2; 3; 张毅斌1; 2; 3; 陈佳艺1; 2; 3; 王玉洁1; 2; 3; 李欢1; 2; 3; 许赪1; 2; 3
1.上海交通大学医学院附属瑞金医院放射治疗科，上海 200025；2.上海市质子治疗转化研究重点实验室，上海 201801；3.医学影像先进技术研究院，上海 201800
Author(s):
ZHOU Hui1;  2;  3;  ZHANG Yibin1;  2;  3;  CHEN Jiayi1;  2;  3;  WANG Yujie1;  2;  3;  LI Huan1;  2;  3;  XU Cheng1;  2;  3
1. Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China; 2. Shanghai Key Laboratory of Proton-therapy, Shanghai 201801, China; 3. Institute for Medical Imaging Technology, Shanghai 201800, China
关键词:
前列腺癌; 质子治疗; 鲁棒性优化; 摆位误差; 剂量学
Keywords:
prostate cancer;  proton therapy;  robust optimization;  setup error;  dosimetry
分类号:
R318；R811.1
DOI:
10.3969/j.issn.1005-202X.2025.05.001
文献标志码:
A
摘要:
探讨不同鲁棒性优化参数对局限期前列腺癌质子治疗计划中危及器官（OARs）和临床靶区（CTV）剂量的影响，以找到最佳的鲁棒性优化参数。回顾性分析10例病例，设计了总剂量为76 Gy、分38次治疗的质子计划。在鲁棒性优化中，考虑3.5%的射程不确定性和3、5、7 mm的摆位误差参数。按摆位误差参数分组，获得3组计划。对比分析摆位误差参数对CTV和OARs剂量的影响，并评估CTV剂量鲁棒性，包括在不同误差场景下CTV剂量学参数的最差值和通过率。结果发现，随着摆位误差参数的增加，OARs的剂量呈现上升趋势。与3 mm计划组相比，5和7 mm计划组中直肠V70分别增加1.99%和5.15%，V45分别增加3.71%和10.01%；膀胱V70分别增加0.93%和2.55%，V45分别增加1.71%和5.27%；乙状结肠及尿道球部剂量参数呈现同样规律，且结果差异有统计学意义（P<0.05）。在鲁棒性分析中，5和7 mm计划组与3 mm计划组相比，CTV的D99分别增加0.68和0.95 Gy，通过率分别提高7.2%和9.6%（通过标准：D95至少达到100%的处方剂量），且结果差异有统计学意义（P<0.05）。综合考虑OARs剂量和CTV鲁棒性，5 mm的摆位误差参数在提高CTV剂量鲁棒性的同时，有效控制OARs剂量的增长，可作为局限期前列腺癌质子治疗计划鲁棒性优化的合理选择。
Abstract:
The effects of different robust optimization parameters on the doses to organs-at-risk (OAR) and the clinical target volume (CTV) in proton therapy plans for localized prostate cancer are explored for identifying the optimal robust optimization parameters. A retrospective analysis is conducted on 10 cases in which proton plans with a total dose of 76 Gy delivered in 38 fractions are designed. In robust optimization, uncertainties of 3.5% in range and setup errors of 3, 5 and 7 mm are considered. After being grouped by setup errors, 3 groups of plans are obtained. The effects of setup errors on the doses to CTV and OAR are analyzed, and the robustness of the CTV dose is assessed, including the worst-case values of dosimetric parameters and the passing rates under different scenarios. The results show that as the setup error increased, the doses to OAR tended to rise. Compared with the 3 mm plan group, the 5 mm and 7 mm plan groups experience increases of 1.99% and 5.15% in rectal V70, 3.71% and 10.01% in rectal V45, 0.93% and 2.55% in bladder V70, and 1.71% and 5.27% in bladder V45, respectively; similar patterns are observed for the doses to sigmoid colon and bulbous urethra, and the differences are statistically significant (P<0.05). In robustness analysis, the CTV D99 in the 5 mm and 7 mm plan groups increases by 0.68 Gy and 0.95 Gy as compared with the 3 mm plan group, with passing rates improving by 7.2% and 9.6%, respectively (passing criterion: D95 receives at least 100% of the prescribed dose), with significant differences (P<0.05). Considering both OAR dose and CTV robustness, the setup error of 5 mm is found to be a reasonable choice for robust optimization in proton therapy plans for localized prostate cancer, as it can effectively balance the enhancement of CTV dose robustness with the control of dose escalation to OAR.

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备注/Memo

备注/Memo:
【收稿日期】2024-12-09【基金项目】国家重点研发计划（2022YFC2404602）；国家科技重大专项（2023ZD0502200）；北京科创医学发展基金会项目（KC2021-JX-0170-9）【作者简介】周晖，硕士，中级物理师，研究方向：医学物理，E-mail: zhouhui2012@yeah.net【通信作者】许赪，博士，副主任医师，研究方向：乳腺癌、前列腺癌放射治疗，E-mail: xucheng60@126.com
更新日期/Last Update: 2025-06-03