【摘要】 目的通过比较宫颈癌经验引导调强(knowledge-based intensity-modulated radiotherapy,K-IMRT)与常规调强(conventional intensity-modulated radiotherapy,C-IMRT)在计划靶区(planning target volume,PTV)和危及器官(organ at risk,OAR)的剂量学差异,探讨基于先验知识的宫颈癌调强计划自动优化的可行性。方法选取山东省肿瘤医院2014-05-01-2014-09-01宫颈癌术后患者10例,进行CT模拟定位、靶区和危及器官的勾画,用Eclipse 13.0治疗计划系统基于同一CT图像进行K-IMRT和C-IMRT调强计划设计。在95%体积的PTV达到处方剂量的条件下,比较两种调强计划的剂量体积直方图(dose volume histogram,DVH),分析靶区均匀性指数(homogeneity index,HI)、适形度指数(conformity index,CI)、OAR受照剂量和计划时间。结果 K-IMRT计划与C-IMRT计划在靶区受照剂量、HI和CI差异均无统计学意义,P>0.05。膀胱V30、左股骨头V40、右股骨头V20、V30和D50K-IMRT计划明显优于C-IMRT计划,差异有统计学意义,P<0.05。膀胱V20、V30和D50,直肠V20、V30和V50及左右股骨头受照剂量均值都低于C-IMRT计划。计划时间K-IMRT明显缩短。结论宫颈癌术后基于先验知识的调强计划自动优化结果可以达到与C-IMRT计划相似的靶区剂量分布,能够降低危及器官的受照受量,在计划优化应用中是可行的。更多还原

【Abstract】 OBJECTIVE To discuss the feasibility of knowledge-based IMRT planning automatic optimization for cervical cancer by comparing the dosimetric differences of the planning target volume(PTV)and the organ at risk(OAR)for postoperative patients with cervical cancer on knowledge-based radiation therapy(K-IMRT)and conventional intensitymodulated radiotherapy(C-IMRT).METHODS From May 1,2014 to September 1,2014,ten postoperative patients with cervical cancer were chosen and their CT scan,PTV and OAR contouring were obtained.K-IMRT plan and C-IMRT plan were performed for each CT image respectively with Eclipse 13.0system.Under the condition of 95% volume of PTV of prescription dose,DVH of two treatment plans,conformal dose of target volume and OARs,HI,CI and planning time were compared.RESULTS The K-IMRT plan compared with C-IMRT planning,dose of PTV,HI and CI had no significant differences(P>0.05).There were significant differences in V20,V30,D50 of bladder,V20,V30,V50 of rectum and femur(P<0.05).CONCLUSION K-IMRT plans,keeping with C-IMRT plans in dose distribution of the target reduces the dose of OARs and are feasible in the plan optimization application.更多还原