CAJ | 학술논문

目的比较Eclipse治疗计划系统笔形束卷积算法(PBC)和各向异性分析算法(AAA)在肺癌调强放疗计划的剂量学差异,并对两种算法进行胸部模体的剂量测量验证.方法选取10例肺癌调强放疗计划,分别使用PBC算法与AAA算法进行剂量计算,比较计划靶体积剂量分布及肺和脊髓受量差异.然后将不同算法的治疗计划移植至模体上,对模体内多点进行验证测量,比较计算值与测量值一致性.对两种算法的剂量比较行配对t检验.结果与PBC算法相比,AAA算法的计划靶体积Dmax更高(t=-4.03,P=0.010)、Dmin更低(t=5.09,P=0.040),处方剂量对计划靶体积覆盖体积减小；AAA算法的肺D mean、V20和脊髓Dmax高于PBC算法(t=-3.99、-2.79、-5.46,P=0.010、0.038、0.003).验证测量结果显示AAA算法计算值与测量值平均偏差＜2％,等中心点处优于PBC算法(t=-3.82,P=0.012).结论肺癌调强放疗计划PBC算法高估了靶区剂量、低估了肺和脊髓剂量,因此推荐使用对组织不均匀处理能力更强的AAA算法.
목적 비교Eclipse치료계화계통필형속권적산법(PBC)화각향이성분석산법(AAA)재폐암조강방료계화적제량학차이,병대량충산법진행흉부모체적제량측량험증.방법 선취10례폐암조강방료계화,분별사용PBC산법여AAA산법진행제량계산,비교계화파체적제량분포급폐화척수수량차이.연후장불동산법적치료계화이식지모체상,대모체내다점진행험증측량,비교계산치여측량치일치성.대량충산법적제량비교행배대t검험.결과 여PBC산법상비,AAA산법적계화파체적Dmax경고(t=-4.03,P=0.010)、Dmin경저(t=5.09,P=0.040),처방제량대계화파체적복개체적감소；AAA산법적폐D mean、V20화척수Dmax고우PBC산법(t=-3.99、-2.79、-5.46,P=0.010、0.038、0.003).험증측량결과현시AAA산법계산치여측량치평균편차＜2％,등중심점처우우PBC산법(t=-3.82,P=0.012).결론 폐암조강방료계화PBC산법고고료파구제량、저고료폐화척수제량,인차추천사용대조직불균균처리능력경강적AAA산법.
Objective To compare the dosimetric differences between pencil beam convolution (PBC) and anisotropic analytical algorithm (AAA) in Eclipse treatment planning system for intensitymodulated radiotherapy (IMRT) planning of lung cancer patients and dosimetric verification.Methods 10 IMRT plans of lung cancer patients were calculated using the PBC and AAA and the differences of dosimetric parameter were analyzed according to dose-volume histogram of planning target volume (PTV),lung and spinal cord.The verification measurements were performed on an inhomogeneous thorax phantom using a pinpoint ionization chamber.The agreement between calculated and measured doses was determined.The paired t test was used to compare the results.Results Compared with PBC,the AAA predicted higher maximum PTV dose (t =-4.03,P =0.010),lower minimum PTV dose (t =5.09,P =0.040),and a reduction of the volume of PTV covered by the prescribed dose.The AAA also predicted slightly increases than the PBC algorithm in the mean dose to the lung and the V20 as well as the maximum dose to the spinal cord,and the differences were statistically significant (t =-3.99,-2.79,-5.46,P =0.010,0.038,0.003).In the verification measurements,the agreement between the AAA and measurement was within 2％and superior to the PBC algorithm on isocenter (t =-3.82,P =0.012).Conclusions For IMRT treatment planning of lung cancer,the PBC algorithm overestimates the dose to the PTV and underestimates the dose to the lung and the spinal cord,so the AAA for treating planning in which the tissue inhomogeneous such as lung is present is recommended.