鼻咽癌調(diào)強放療計劃十分復(fù)雜, 計劃質(zhì)量通常與治療劑量師的經(jīng)驗密切相關(guān)。本研究納入了10例不同分期的鼻咽癌患者, 基于Pinnacle3 9.2治療計劃系統(tǒng)腳本, 運用計算機程序設(shè)置計劃的基本參數(shù)、目標參數(shù)等, 最終自動完成鼻咽癌調(diào)強放療計劃。然后, 對自動和手動調(diào)強放療計劃進行統(tǒng)計學(xué)比較和臨床評估。結(jié)果顯示兩種計劃中大多數(shù)靶區(qū)和危及器官劑量學(xué)參數(shù)的差異無統(tǒng)計學(xué)意義。本文所述的鼻咽癌自動調(diào)強放療計劃能夠滿足臨床放療要求, 顯著減少計劃時間, 同時避免因為經(jīng)驗不足等人為因素對計劃質(zhì)量造成的影響。
【摘要】 目的 研究Monaco治療計劃系統(tǒng)中不同參數(shù)設(shè)置對容積旋轉(zhuǎn)調(diào)強放射治療(VMAT)計劃質(zhì)量的影響，得出更合理的治療計劃參數(shù)設(shè)置以提高VMAT治療質(zhì)量?！》椒ā?010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)置不同的計劃參數(shù)進行容積旋轉(zhuǎn)調(diào)強計劃優(yōu)化，通過多種評估指標比較各VMAT計劃質(zhì)量的差異，得出臨床所需的MSC、MSS、SSF、Sm、MMS和MDR共6個治療計劃參數(shù)對VMAT治療質(zhì)量的影響?！〗Y(jié)果 MSC、MSS和SSF的3個參數(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計劃的劑量分布逐漸變差，但控制點數(shù)、機器跳數(shù)和照射時間均逐漸減?。浑S著MDR值增大，VMAT治療的劑量分布先逐漸變差后不變，控制點數(shù)和機器跳數(shù)均是先增大后不變，而照射時間是先減小后不變?！〗Y(jié)論 Sm、MMS和MDR 3個參數(shù)對VMAT計劃質(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.