CAJ | 학술논문

目的：提出新的定量评估指标———弧形野调制复杂度分数（ AMCS），并分析6种量化计划复杂性指标对VMAT剂量验证的影响。方法定量计算127例患者VMAT计划复杂性指标：平均射野面积（ ABA）、平均叶片路径（ ALT）、平均射野宽度（ ABW）、调制复杂度分数（ MCS）、叶片路径?调制复杂度分数（ LTMCS）和AMCS。采用Delta4系统测量VMAT剂量验证γ通过率。 Pearson法分析ABA、ALT、ABW、MCS、LTMCS和AMCS与3 mm／3％下γ通过率相关性，以及6个指标间的相互关系。结果 ABA、ALT、ABW、MCS、LTMCS和AMCS平均值分别为（73．5±24．1） cm2、（69．6±9．8） cm、（3．63±1．03） cm、0．33±0．05、0．14±0．04和0．16±0．05，且均与γ通过率相关（P＝0．000），其中AMCS与γ通过率相关性最大（ r＝0．637）；AMCS＜平均值时γ通过率＜95％的射野比为60．7％，＞平均值时为9．9％。 ABA、ABW与ALT无相关性（P＝0．720、0．073），其余指标间均相关（P＝0．000～0．003）。结论 AMCS指标是一种适合用于定量评估VMAT计划复杂性的方法，可用于预测VMAT剂量验证结果，在VMAT计划审核中用于比较多个计划的复杂度以帮助选择最佳计划。
목적：제출신적정량평고지표———호형야조제복잡도분수（ AMCS），병분석6충양화계화복잡성지표대VMAT제량험증적영향。방법정량계산127례환자VMAT계화복잡성지표：평균사야면적（ ABA）、평균협편로경（ ALT）、평균사야관도（ ABW）、조제복잡도분수（ MCS）、협편로경?조제복잡도분수（ LTMCS）화AMCS。채용Delta4계통측량VMAT제량험증γ통과솔。 Pearson법분석ABA、ALT、ABW、MCS、LTMCS화AMCS여3 mm／3％하γ통과솔상관성，이급6개지표간적상호관계。결과 ABA、ALT、ABW、MCS、LTMCS화AMCS평균치분별위（73．5±24．1） cm2、（69．6±9．8） cm、（3．63±1．03） cm、0．33±0．05、0．14±0．04화0．16±0．05，차균여γ통과솔상관（P＝0．000），기중AMCS여γ통과솔상관성최대（ r＝0．637）；AMCS＜평균치시γ통과솔＜95％적사야비위60．7％，＞평균치시위9．9％。 ABA、ABW여ALT무상관성（P＝0．720、0．073），기여지표간균상관（P＝0．000～0．003）。결론 AMCS지표시일충괄합용우정량평고VMAT계화복잡성적방법，가용우예측VMAT제량험증결과，재VMAT계화심핵중용우비교다개계화적복잡도이방조선택최가계화。
Objective To study a new quantitative method—arc?beam modulation complexity score ( AMCS) to evaluate the plan complexity of volumetric?modulated arc therapy ( VMAT) ,and the effect of the six metrics on VMAT dosimetric verification. Methods The six metrics,which contain the average of beam area ( ABA ) , the average of leaf travel ( ALT ) , the average of beam width ( ABW ) , the modulation complexity score ( MCS ) , the leaf travel and modulation complexity score ( LTMCS ) and AMCS, was calculated to quantify the plan complexity of VMAT for 127 selected patients. Delta4 system was used for verifying the VMAT plans and the γ pass rate was calculated. The relativity between the six metrics and the pass rates or between the 6 parameters were analyzed with Pearson method. Results The average of ABA, ALT,ABW,MCS,LTMCS and AMCS were (73.5±24. 1) cm2,(69.6±9. 8) cm,(3.63±1. 03) cm,0.33± 0. 05,0.14±0. 04 and 0.16± 0. 05,respectively. A negative correlation was observed for ALT and the pass rate,and the other metrics had a positive correlation with it (P=0. 000).The correlation between AMCS and the pass rate was the strongest with Pearson’ s ( r=0. 637) in the six metrics. The percentage of arcs with a pass rate lower the 95% was 60. 7 when AMCS is lower than the average,while it was 9. 9% when AMCS is higher than the average. Both ABA and ABW had no significant correlation with ALT ( P=0. 720,0. 073) , and the other metrics had significant correlations ( P=0. 000?0. 003 ) . Conclusions AMCS is a suitable quantitative metric to evaluate the plan complexity of VMAT, and could be used to forecast the result of dosimetric verification of VMAT plans. It could be also use to compare the multiple VMAT plans complexity and help us to choose the best plan.