【摘要】 目的探讨Auto-planning技术用于食管癌调强放疗计划设计的可行性。方法选取24例食管癌放疗病例,用Pinnacle³计划系统设计自动治疗计划（ap-IMRT）和人工计划（m-IMRT）,比较两种不同计划的剂量体积直方图（DVH）,用配对t检验分析靶区和危及器官受照剂量的差异。结果肿瘤靶区GTV的D_min（t=-2.233,P=0.036）、均匀性指数HI（t=2.205,P=0.038）,计划靶区PTV的D₉₈（t=-2.241,P=0.035）、HI（t=2.543,P=0.018）、适形度指数CI（t=-2.497,P=0.020）,左肺V₂₀（t=4.412,P=0.000）、V₃₀（t=5.243,P=0.000）,心脏V₃₀（t=2.546,P=0.018）、V₄₀（t=2.404,P=0.025）、D_mean（t=2.565,P=0.017）,以上参数均是ap-IMRT计划优于m-IMRT。脊髓最大受照剂量D_max（t=-1.891,P=0.045）,m-IMRT计划优于ap-IMRT。结论 ap-IMRT靶区剂量分布能够达到较好均匀性和适形度,且能更地保护并行器官,但对串行器官脊髓的保护欠佳。更多还原

【Abstract】 Objective To explore the feasibility of auto-planning in the design of intension-modulated Radiotherapy（IMRT） plans for Mid-esophageal Cancer Patients. Methods A total of 24 radiotherapy esophageal cancer patients were selected. The automatic treatment plan（ap-IMRT） and manual treatment plan（m-IMRT） were designed respectively by Pinnacle³ treatment planning system.The dose volume histograms（DVH） of the two plans were compared and the dose difference between the target area and organs at risk was analyzed by paired t test. Results The ap-IMRT plan were significantly better than the m-IMRT in the target area terms of Dmin（t=-2.233,P=0.036） and uniformity index（HI）（t=2.205,P=0.038） of Gross tumor volume（GTV）,D98（t=-2.241,P=0.035）,HI（t=2.543,P=0.018） and conformity index CI（t=-2.497,P=0.020） of planning target volume（PTV）. The ap-IMRT plans were significantly better than the m-IMRT in the organs at risk terms of the left lung V₂₀（t=4.412,P=0.000） and V₃₀（t=5.243,P=0.000）,heart V₃₀（t=2.546,P=0.018）,V₄₀（t=2.404,P=0.025） and D_mean（t=2.565,P=0.017）. The m-IMRT plans were significantly better than the ap-IMRT in the term of the maximum dose of spinal cord D_max（t =-1.891,P=0.045）. Conclusion Compared with m-IMRT plans, the dose distribution of ap-IMRT target area can achieve better uniformity and conformity, and can better protect parallel organs, but the protection of serial organs spinal cord is not good enough.更多还原