• 四川大學(xué)華西醫(yī)院（成都，610041）1 放射物理技術(shù)中心，2 腫瘤中心;

【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。　方法　 2010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VMAT治療質(zhì)量的影響。　結(jié)果　 MSC、MSS和SSF的3個(gè)參數(shù)對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??；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VMAT計(jì)劃質(zhì)量有較大影響，對不同的患者，設(shè)置合適的Sm、MMS和MDR值對提高計(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.

引用本文： 李光俊,吳魁,姜慶豐,肖江洪,陳念永,柏森. Monaco治療計(jì)劃系統(tǒng)中參數(shù)設(shè)置對容積旋轉(zhuǎn)調(diào)強(qiáng)放射治療計(jì)劃質(zhì)量的影響. 華西醫(yī)學(xué), 2010, 25(12): 2133-2137. doi: 復(fù)制

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  2. 2. 　Webb S. The physical basis of IMRT and inverse planning[J]. Br J Radiol, 2003, 76(10): 678-689.
  3. 3. 　Vanetti E, Clivio A, Nicolini G, et al. Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT[J]. Radiother Oncol, 2009, 92(1): 111-117.
  4. 4. 　Verbakel WF, Senan S, Cuijpers JP, et al. Rapid delivery of stereotactic radiotherapy for peripheral lung tumors using volumetric intensity-modulated arcs[J]. Radiother Oncol, 2009, 93(2): 122-124.
  5. 5. 　Bortfeld T, Webb S. Single-arc IMRT?[J]. Phys Med Biol, 2009, 54: 9-20.
  6. 6. 　Fippel M. Fast Monte Carlo dose calculation for photon beams based on the VMC electron algorithm[J]. Med Phys, 1999, 26(8): 1466-1475.
  7. 7. 　Fippel M, Laub W, Huber B, et al. Experimentel investigation of a fast Monte Carlo photon beam dose calculation algorithm[J]. Phys Med Biol, 1999, 44(12): 3039-3054.
  8. 8. 　Feuvret L, Noel G, Mazeron JJ, et al. Conformity index: a review[J]. Int J Radiat Oncol Biol Phys, 2006, 64(2): 333-342.
  9. 9. 　Bertelsen A, Hansen CR, Johansen J, et al. Single Arc Volumetric Modulated Arc Therapy of head and neck cancer [J]. Radiother Oncol, 2010, 95(2): 142-148.
  10. 10. 　Alber M, Nusslin F. An objective function for radiation treatment optimization based on local biological measures[J]. Phys Med Biol, 1999, 44(2): 479-493.
  11. 11. 　Bar W, Alber M, Nusslin F. A variable fluence step clustering and segmentation algorithm for step and shoot IMRT[J]. Phys Med Biol, 2001, 46(7): 1997-2007.