[1]姚凯宁,王美娇,刘嘉城,等.Ethos系统下乳腺癌旋转调强计划质量优化[J].中国医学物理学杂志,2026,43(1):1-8.[doi:DOI:10.3969/j.issn.1005-202X.2026.01.001]
　YAO Kaining,WANG Meijiao,LIU Jiacheng,et al.Quality optimization of volumetric modulated arc therapy plans for breast cancer via Ethos system[J].Chinese Journal of Medical Physics,2026,43(1):1-8.[doi:DOI:10.3969/j.issn.1005-202X.2026.01.001]
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Ethos系统下乳腺癌旋转调强计划质量优化()

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

卷:
43卷
期数:
2026年第1期
页码:
1-8
栏目:
医学放射物理
出版日期:
2026-01-26

文章信息/Info

Title:
Quality optimization of volumetric modulated arc therapy plans for breast cancer via Ethos system
文章编号:
1005-202X（2026）01-0001-08
作者:
姚凯宁; 王美娇; 刘嘉城; 石晨; 岳海振; 吴昊; 杜乙; 王若曦
北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科/恶性肿瘤发病机制及转化研究教育部重点实验室， 北京 100142
Author(s):
YAO Kaining;  WANG Meijiao;  LIU Jiacheng;  SHI Chen;  YUE Haizhen;  WU Hao;  DU Yi;  WANG Ruoxi
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing)/Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
关键词:
Ethos系统; 自动计划; 自定义射野; 乳腺癌; 放射放疗
Keywords:
Keywords: Ethos system automatic planning customized field arrangement breast cancer radiotherapy
分类号:
R318；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2026.01.001
文献标志码:
A
摘要:
目的：针对Ethos 2.0计划系统在乳腺癌放疗中固定射野组合导致剂量分布不满足临床要求的问题，提出一种联合Eclipse预计划射野的改进方案，通过自定义射野确保复杂计划质量、提升计划设计效率。方法：回顾性选取20例右侧乳腺癌伴前哨淋巴结转移病例，临床分期为T1-2N1M0，根据ESTRO指南勾画靶区和危及器官。在Eclipse系统中设计预计划，导入Ethos系统后结合智能优化引擎进行计划重优化。随后利用Eclipse系统对Ethos自定义射野自动计划和Eclipse参考计划比较评估，主要评估指标为靶区剂量覆盖和适形度及危及器官受量。结果：自定义射野的Ethos计划靶区和危及器官剂量均满足临床要求。与Eclipse原计划相比，PTVbreast和PTVboost的适形度分别从0.84和0.73提升至0.90和0.81，PTVboost的V107%降低7.71%，肝脏Dmean降低0.67 Gy，差异均有统计学意义（P<0.05）。Ethos的自动计划缩短人机交互时间达90%，显著降低物理师工作负荷。结论：本研究建立的联合工作流程突破了Ethos系统在乳腺癌放疗中的射野限制，Ethos自定义射野计划能够与Eclipse计划达到几乎相同的水平，同时显著提升计划效率，为复杂乳腺癌病例提供了标准化流程，为乳腺放疗自适应技术提供了可扩展的射野设计框架。
Abstract:
Abstract: Objective To address the issue of the suboptimal dose distribution caused by the fixed field arrangements in Ethos 2.0 planning system for breast cancer radiotherapy, an improved workflow integrating Eclipse pre-planned fields is proposed for ensuring the quality of complex treatment plans and enhancing the efficiency of plan design through customized field arrangements. Methods? retrospective analysis was conducted on 20 patients with right-sided breast cancer and sentinel lymph node metastasis, classified as clinical stage T1-2N1M0. Target areas and organs-at-risk were contoured in accordance with the ESTRO guidelines. Pre-plans were designed using the Eclipse planning system and then imported into Ethos system for re-optimization via its intelligent optimization engine. Subsequently, a comparison of Ethos automatic plans with customized field arrangements against Eclipse reference plans was conducted in Eclipse system, focusing on target coverage, conformity index, and organ-at-risk doses. Results?oth the target doses and organs-at-risk doses of the Ethos plans with customized field arrangements met clinical requirements. Compared with the Eclipse reference plans, the Ethos plans with customized field arrangements improved the conformity index of PTVbreast and PTVboost from 0.84 to 0.90 and from 0.73 to 0.81, respectively, decreased V107% of PTVboost by 7.71%, and reduced the mean liver dose by 0.67 Gy, with all differences being statistically significant (P<0.05). The Ethos automatic workflow reduced human-computer interaction time by 90%, substantially alleviating the workload of physicists. Conclusion?he integrated workflow established in this study overcomes the field arrangement limitations of the Ethos system in breast cancer radiotherapy. Ethos plans with customized field arrangements achieves near-identical quality to that of Eclipse plans while significantly improving planning efficiency. This workflow provides a standardized procedure for complex breast cancer cases and an extensible field arrangement framework for adaptive breast radiotherapy techniques.

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备注/Memo

备注/Memo:
【收稿日期】2025-05-16 【基金项目】国家自然科学基金（12375335，12005007）；北京市自然科学基金（25JL001）；北京大学肿瘤医院科学研究基金（ZY202410） 【作者简介】姚凯宁，工程师，研究方向：放射治疗物理，E-mail: kainingyao@163.com 【通信作者】王若曦，高级工程师，研究方向：医学物理，E-mail: ruoxi.wang@pku.edu.cn
更新日期/Last Update: 2026-01-26