[1]朱皓,贾晓斌,朱伟华,等.ASC算法在鼻咽癌容积调强放射治疗中的应用[J].中国医学物理学杂志,2020,37(5):545-551.[doi:10.3969/j.issn.1005-202X.2020.05.004]
　ZHU Hao,JIA Xiaobin,ZHU Weihua,et al.Application of ASC algorithm in volumetric modulated arc therapy for nasopharyngeal carcinoma[J].Chinese Journal of Medical Physics,2020,37(5):545-551.[doi:10.3969/j.issn.1005-202X.2020.05.004]
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ASC算法在鼻咽癌容积调强放射治疗中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第5期
页码:
545-551
栏目:
医学影像物理
出版日期:
2020-05-25

文章信息/Info

Title:
Application of ASC algorithm in volumetric modulated arc therapy for nasopharyngeal carcinoma
文章编号:
1005-202X（2020）05-0545-07
作者:
朱皓1; 贾晓斌2; 朱伟华1; 张震1; 韩增伟2
1. 瓦里安医疗系统公司临床应用培训部，北京102600；2. 上海交通大学医学院附属第九人民医院放疗科，上海201900
Author(s):
ZHU Hao1;  JIA Xiaobin2;  ZHU Weihua1;  ZHANG Zhen1;  HAN Zengwei2
1.Clinical Application Training Department of Varian Medical Systems, Inc., Beijing 102600, China 2.Department of Radiotherapy, the Ninth Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 201900, China
关键词:
鼻咽癌; 容积调强放射治疗; 射束形态控制器; 可视化脚本; 射束孔不规则度; 计划复杂度
Keywords:
nasopharyngeal carcinoma volumetric modulated arc therapy aperture shape controller visual scripting aperture irregularity plan complexity index
分类号:
R815；R811.1
DOI:
10.3969/j.issn.1005-202X.2020.05.004
文献标志码:
A
摘要:
[摘要] 目的：基于ESAPI脚本与可视化脚本（Visual Scripting），评估分析射束形态控制器（Aperture Shape Controller）算法在鼻咽癌容积调强（RapidArc）中的应用。方法：采用Eclipse v15.5计划系统对40例鼻咽癌患者做回顾性分析，每位患者制定六组容积调强（RapidArc）计划。对照组（ASC-no）设置为off；实验Ⅰ组（ASC-verylow）设置为verylow；实验Ⅱ组（ASC-low）设置为 low；实验Ⅲ组（ASC-moderate）设置为moderate；实验Ⅳ组（ASC-high）设置为high；实验Ⅴ组（ASC-veryhigh）设置为veryhigh，且所有计划的优化参数均相同。采用Eclipse v15.5内置可视化脚本与ESAPI脚本编译，评估各组计划之间的靶区与危及器官剂量学差异，进一步分析射束孔不规则度（Aperture irregularity, AI）与计划复杂度（Plan complexity index, PCI）的变化。结果：相比于照组（ASC-no），实验组PGTV69的CI未有统计学差异；而实验组PGTV69和PCTV1的HI均存在统计学差异（P<0.05），且随着ASC权重的增大而呈现增加趋势；对于PCTV2的HI，实验组中II组ASC-low、III组ASC- moderate和IV组ASC-high存在统计学差异（P<0.05）。危及器官中，Spinal cord的Dmax、Larynx的Dmean、Parotid-L的Dmean仅V组ASC-veryhigh存在统计学差异(P<0.05)；I组ASC-verylow的Brainstem的Dmax存在统计学差异(P<0.05)；II组ASC-low的Parotid-R 的V30存在统计学差异(P<0.05)；I组ASC-verylow和V组ASC-veryhigh的Len 的Dmax存在统计学差异(P<0.05)；III组ASC-moderate、IV组ASC-high和V组ASC-veryhigh的Pituitary的Dmax存在统计学差异(P<0.05)。此外实验组计划中，I组ASC-verylow组和II组ASC-low组total MU值存在统计学差异(P<0.05)，其余各实验组变化差异无统计学差异。随着通ASC权重值的增加，计划复杂度PCI与射束孔不规则度AI均呈现降低趋势。结论：相较于对照组，ASC算法改善了计划复杂度和射野不规则度。其中，低权重ASC降低计划执行Total MU，高权重ASC则无显著差异。此外，高权重ASC也影响靶区均匀性以及其他剂量学指标。综合考虑计划质量和投照效率，对于鼻咽癌类型的复杂放疗计划，建议ASC权重设置为verylow、low和moderate。
Abstract:
Objective To analyze and evaluate the application of aperture shape controller (ASC) algorithm in volumetric modulated arc therapy (RapidArc) for nasopharyngeal carcinoma based on ESAPI and visual scripting. Methods The clinical information of 40 patients with nasopharyngeal carcinoma was analyzed retrospectively, and Eclipse v15.5 treatment planning system was used to design 6 RapidArc plans for each patient. The 6 groups of plans included control group (ASC-no), experimental group Ⅰ (ASC-verylow), experimental group Ⅱ (ASC-low), experimental group Ⅲ (ASC-moderate), experimental group Ⅳ (ASC-high) and experimental group Ⅴ (ASC-veryhigh), and the other optimization parameters of all plans were set as the same. The ESAPI and visual scripting of Eclipse v15.5 were used to assess the dosimetric differences in target areas and organs-at-risk and further analyze the variations of aperture irregularity and plan complexity index. Results No statistical difference was found in the conformity index of PGTV69 between control group and experimental groups, but the homogeneity index (HI) of PGTV69 and PCTV1 in experimental groups was higher than that in control group, with statistical differences (P<0.05), and the difference in HI showed an increasing trend with the increase of ASC weight. For the HI of PCTV2, there were statistical differences between control group and experimental groups II, III and IV (P<0.05). Compared with the dosimetric parameters of organs-at-risk in control group, there were statistical differences in the Dmaxof spinal cord, the Dmean of larynx and parotid-L in experimental group V (P< 0.05) the Dmean of brainstem in experimental group I (P<0.05) the V30 of parotid-R in experimental group II (P<0.05) the Dmean of lens in experimental groups I and V (P<0.05) and the Dmax of pituitary in experimental groups III, IV and V (P<0.05). Among the experimental groups, there was statistical differences in total machine monitors between experimental group I and experimental group II (P<0.05).As theASC weight increasing, both aperture irregularity and plan complexity index showed a decreasing trend. Conclusion ASC algorithm improves plan complexity index and aperture irregularity.Among them, theASC of low weight reduces machine monitors, and the ASC of high weight affects the homogeneity of target areas and other dosimetric indicators. Based on the comprehensive consideration of plan quality and delivery efficiency, the ASC weight is recommended to be set as verylow, low and moderate for nasopharyngeal carcinoma and other complex radiotherapy plans.

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备注/Memo

备注/Memo:
【收稿日期】2020-03-26 【作者简介】朱皓，硕士，中级临床培训工程师，研究方向：肿瘤放射物理及放射剂量学，E-mail: Hao.Zhu@varian.com；贾晓斌，研究方向：放射物理与 医学影像，E-mail: 1337643544@qq.com（朱皓与贾晓斌为共同第一作者）
更新日期/Last Update: 2020-06-03