[1]刘登洪,王雪桃,钟仁明.几何不确定性鲁棒优化在肝癌立体定向放疗中的应用[J].中国医学物理学杂志,2022,39(2):162-168.[doi:DOI:10.3969/j.issn.1005-202X.2022.02.006]
　LIU Denghong,WANG Xuetao,ZHONG Renming.Application of geometric uncertainty-based robust optimization in stereotactic body radiotherapy for liver cancer[J].Chinese Journal of Medical Physics,2022,39(2):162-168.[doi:DOI:10.3969/j.issn.1005-202X.2022.02.006]
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几何不确定性鲁棒优化在肝癌立体定向放疗中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第2期
页码:
162-168
栏目:
医学放射物理
出版日期:
2022-02-26

文章信息/Info

Title:
Application of geometric uncertainty-based robust optimization in stereotactic body radiotherapy for liver cancer
文章编号:
1005-202X（2022）02-0162-07
作者:
刘登洪; 王雪桃; 钟仁明
四川大学华西临床医学院（华西医院）肿瘤中心放疗科（生物治疗国家重点实验室）， 四川 成都 610041
Author(s):
LIU Denghong;  WANG Xuetao;  ZHONG Renming
Department of Radiotherapy (State Key Laboratory of Biotherapy), Cancer Center, West China School of Medicine (West China Hospital), Sichuan University, Chengdu 610041, China
关键词:
肝癌; 立体定向放疗; 鲁棒优化; 几何不确定性
Keywords:
Keywords: liver cancer stereotactic body radiotherapy robust optimization geometric uncertainty
分类号:
R318；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2022.02.006
文献标志码:
A
摘要:
目的：分析基于几何不确定性的鲁棒优化计划对肝癌立体定向放疗（SBRT）剂量分布的影响。方法：选取12例肝癌SBRT患者，对每例制作3个调强计划：①基于PTV（ITV-PTV 5 mm）的常规优化（PTV-Based Plan）；②基于ITV非均匀几何不确定性（本中心计算的不确定性值：进出方向7 mm，左右和前后方向4 mm）的鲁棒优化（Robust Planactual）；③基于ITV均匀5 mm几何不确定性的鲁棒优化（Robust Plan5 mm）。所有计划都以95%的PTV满足处方剂量作为目标，以等中心均匀偏移4、5、7 mm计算扰动剂量评估鲁棒性。结果：计划①②③的均匀性指数（HI）分别为0.083±0.027、0.099±0.035、0.096±0.026，不具有统计学意义；计划①②③的适形性指数（CI）分别为0.98±0.02、1.02±0.05、1.00±0.04，计划②③相对于计划①的CI具有统计学意义。计划③的正常肝组织平均受量和V2500相对于计划①②分别下降了4.1%、2.5%和5.4%、3.0%，且具有统计学意义（P=0.034、P=0.021和P=0.004、P=0.004），计划②相对于计划①的正常肝组织平均受量和V2500不具有统计学意义（P=0.308和P=0.182），但下降了1.6%和2.5%。对于其鲁棒性，计划②③的5 mm-D99%、5 mm-D98%、5 mm-D95%的剂量-体积直方图带宽（DVHBW）差值相对于计划①更小，随着摆位不确定度的增大，其DVHBW差值越大。结论：在肝脏SBRT治疗中，采用鲁棒优化能够提高靶区剂量分布质量，即使在摆位不确定度有所增加的情况下，仍可以保证ITV的剂量覆盖同时不增加正常组织的照射剂量。
Abstract:
Abstract: Objective To analyze the effects of robust optimization plan based on geometric uncertainty on the dose distribution of stereotactic body radiotherapy (SBRT) for liver cancer. Methods Twelve patients treated by SBRT for liver cancer were enrolled in the study. For each case, 3 different kinds of plans were designed by different optimization methods, including ① conventional optimization (PTV-Based Plan) based on PTV (ITV-PTV 5 mm), ② robust optimization (Robust Planactual) based on non-uniform geometric uncertainty for ITV (the uncertainties calculated by our center were 7 mm in superior-inferior direction, 4 mm in medial-lateral and anterior-posterior directions), ③ robust optimization (Robust Plan5 mm) based on uniform geometric uncertainty of 5 mm for ITV. All plans were based on the target that 95% ITV met the prescribed dose, and the perturbation dose was calculated with uniform uncertainties of 4, 5, 7 mm from the isocenter to evaluate the robustness. Results The homogeneity index of plans ①②③ was 0.083±0.027, 0.099±0.035 and 0.096±0.026, respectively, without statistical significance and the conformity index of plans ②③ was 1.02±0.05, 1.00±0.04, significantly different from that of plan ① which was 0.98±0.02. Compared with those in plans ①②, the average dose to normal liver tissues in plan ③ was decreased by 4.1% and 2.5% (P=0.034, P=0.021), and V2500 was decreased by 5.4% and 3.0% (P=0.004, P=0.004), respectively. The average dose to normal liver tissue and V2500 in plan ② were not statistically different from those in plan ① (P=0.308 and P=0.182), but decreased by 1.6% and 2.5%. For robustness, the differences in dose-volume histogram bandwidth (DVHBW) of 5 mm-D99%, 5 mm-D98%, 5 mm-D95% in plans ②③ were smaller than those in plan ①. With the increase of setup uncertainty, the difference in DVHBW became greater. Conclusion In liver SBRT, robust optimization can optimize target dose distribution. Even if the setup uncertainty increases, it can still ensure the dose coverage of ITV, without increasing the irradiation dose to normal tissues.

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备注/Memo

备注/Memo:
【收稿日期】2021-10-14 【基金项目】四川大学华西医院临床研究孵化项目（2021HXFH029）；四川省科技厅重点研发项目（2021YFQ0065） 【作者简介】刘登洪，E-mail: 1098179133@qq.com 【通信作者】钟仁明，博士，研究方向：放射物理技术，E-mail: zrm_100@163.com
更新日期/Last Update: 2022-03-07