应用射野角度和多目标优化提高肺癌放疗计划的执行效率
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摘要
背景与目的:呼吸运动会给肺癌的放疗带来不利影响,而提高放疗计划的执行效率会在一定程度上减轻这一影响。该研究旨在探究运用射野角度和多目标优化(beam angle and multicriteria optimization,BAMCO)技术进行肺癌放疗计划设计的可行性和执行效率。方法:将10个肺癌临床计划数据由Pinnacle计划系统导出到RayStation计划系统。在RayStation系统中新建计划,以对应的临床计划射野角度为初始条件,在三维适形模块下优化射野角度。以优化结果为基础,执行多目标优化(multicriteria optimization,MCO),导航并确定临床需要的最佳妥协方案,然后生成可执行计划。最后,对比分析BAMCO计划和临床计划。结果:BAMCO计划设计不需要反复试错,一次MCO优化可确定最优计划;BAMCO计划和临床计划的靶区剂量分布和危及器官受量差异无统计学意义。BAMCO计划的跳数相比临床计划明显减少(31.1%±16.9%)。结论:BAMCO技术在保证计划质量的前提下,可有效提升计划的执行效率。
Background and purpose: Respiratory motion may adversely affect radiotherapy for lung cancer, and improving plan delivery efficiency can alleviate this effect to some extent. The aim of this study was to investigate the feasibility of using beam angle and multicriteria optimization(BAMCO) to conduct the treatment planning of lung cancer radiotherapy and the delivery efficiency.Methods: We extracted the planning data of 10 lung cancer patients from Pinnacle treatment planning system, and then created new plan in RayStation system. The corresponding clinical beam set was used as initial reference to conduct beam angle optimization. The obtained beams were used as final beam set to complete multicriteria optimization(MCO). We selected the best clinical compromise and generated deliverable plan. Finally, the clinical and BAMCO plans were compared. Results: BAMCO plan design could determine the best plan after one-time optimization and avoid trial-and-error process. The plan qualities of clinical and BAMCO plans were similar. The machine units of BAMCO were much lower than those of clinical ones(31.1%±16.9%). Conclusion:BAMCO technique can improve delivery efficiency significantly and guarantee good plan quality.
Background and purpose: Respiratory motion may adversely affect radiotherapy for lung cancer, and improving plan delivery efficiency can alleviate this effect to some extent. The aim of this study was to investigate the feasibility of using beam angle and multicriteria optimization(BAMCO) to conduct the treatment planning of lung cancer radiotherapy and the delivery efficiency.Methods: We extracted the planning data of 10 lung cancer patients from Pinnacle treatment planning system, and then created new plan in RayStation system. The corresponding clinical beam set was used as initial reference to conduct beam angle optimization. The obtained beams were used as final beam set to complete multicriteria optimization(MCO). We selected the best clinical compromise and generated deliverable plan. Finally, the clinical and BAMCO plans were compared. Results: BAMCO plan design could determine the best plan after one-time optimization and avoid trial-and-error process. The plan qualities of clinical and BAMCO plans were similar. The machine units of BAMCO were much lower than those of clinical ones(31.1%±16.9%). Conclusion:BAMCO technique can improve delivery efficiency significantly and guarantee good plan quality.
引文
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[24]HU W,WANG J,LI G,et al.Investigation of plan quality between RapidArc and IMRT for gastric cancer based on a novel beam angle and multicriteria optimization technique[J].Radiother Oncol,2014,111(1):144-147.
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[26]OOZEER R,CHAUVET B,GARCIA R,et al.Dosimetric evaluation of conformal radiotherapy:conformity factor[J].Cancer Radiother,2000,4(3):207-216.
[2]KNYBEL L,CVEK J,MOLENDA L,et al.Analysis of lung tumor motion in a large sample:patterns and factors influencing precise delineation of internal target volume[J].Int J Radiat Oncol Biol Phys,2016,96(4):751-758.
[3]JONES D.ICRU report 50-prescribing,recording and reporting photon beam therapy[J].Med Phys,1994,21(6):833-834.
[4]CHAVAUDRA J,BRIDIER A.Definition of volumes in external radiotherapy:ICRU reports 50 and 62[J].Cancer Radiother,2001,5(5):472-478.
[5]VAN DER HEYDEN B,VAN HOOF S J,SCHYNS L E,et al.The influence of respiratory motion on dose delivery in a mouse lung tumor irradiation using the 4D MOBY phantom[J].Br JRadiol,2017,90(1069):20160419.
[6]CHOI H S,KANG K M,JEONG B K,et al.Analysis of motiondependent clinical outcome of tumor tracking stereotactic body radiotherapy for prostate cancer[J].J Korean Med Sci,2018,33(14):e107.
[7]MUTAF Y D,SCICUTELLA C J,MICHALSKI D,et al.A simulation study of irregular respiratory motion and its dosimetric impact on lung tumors[J].Phys Med Biol,2011,56(3):845-859.
[8]MAH D,HANLEY J,ROSENZWEIG K E,et al.Technical aspects of the deep inspiration breath-hold technique in the treatment of thoracic cancer[J].Int J Radiat Oncol Biol Phys,2000,48(4):1175-1185.
[9]DAWSON L,BROCK K,KAZANJIAN S,et al.The reproducibility of organ position using active breathing control(ABC)during liver radiotherapy[J].Int J Radiat Oncol Biol Phys,2001,51(5):1410-1421.
[10]BOUILHOL G,AYADI M,RIT S,et al.Is abdominal compression useful in lung stereotactic body radiation therapy?A 4DCT and dosimetric lobe-dependent study[J].Phys Med,2013,29(4):333-340.
[11]KUBO H,HILL B.Respiration gated radiotherapy treatment:a technical study[J].Phys Med Biol,1996,41(1):83-91.
[12]VEDAM S,KEALL P,KINI V,et al.Determining parameters for respiration-gated radiotherapy[J].Med Phys,2001,28(10):2139-2146.
[13]BALLHAUSEN H,LI M,GANSWINDT U,et al.Shorter treatment times reduce the impact of intra-fractional motion:a real-time 4DUS study comparing VMAT vs step-and-shoot IMRT for prostate cancer[J].Strahlenther Onkol,2018(3):1-11.
[14]TEOH M,CLARK C H,WOOD K,et al.Volumetric modulated arc therapy:a review of current literature and clinical use in practice[J].Br J Radiol,2011,84(1007):967-996.
[15]PUGACHEV A,LI J G,BOYER A L,et al.Role of beam orientation optimization in intensity-modulated radiation therapy[J].Int J Radiat Oncol Biol Phys,2001,50(2):551-560.
[16]YANG R,DAI J,YANG Y,et al.Beam orientation optimization for intensity-modulated radiation therapy using mixed integer programming[J].Phys Med Biol,2006,51(15):3653-3666.
[17]SRIVASTAVA S P,DAS I J,KUMAR A,et al.Dosimetric comparison of manual and beam angle optimization of gantry angles in IMRT[J].Med Dosim,2011,36(3):313-316.
[18]CHANG D S,BARTLETT G K,DAS I J,et al.Beam angle selection for intensity-modulated radiotherapy(IMRT)treatment of unresectable pancreatic cancer:are non-coplanar beam angles necessary[J].Clin Transl Oncol,2013,15(9):720-724.
[19]MONZ M,KüFER K H,BORTFELD T R,et al.Pareto navigation:algorithmic foundation of interactive multi-criteria IMRT planning[J].Phys Med Biol,2008,53(4):985-998
[20]THIEKE C,KüFER K H,MONZ M,et al.A new concept for interactive radiotherapy planning with multi-criteria optimization:first clinical evaluation[J].Radiother Oncol,2007,85(2):292-298.
[21]HONG T S,CRAFT D L,CARLSSON F,et al.Multi-criteria optimization in intensity-modulated radiation therapy treatment planning for locally advanced cancer of the pancreatic head[J].Int J Radiat Oncol Biol Phys,2008,72(4):1208-1214.
[22]CRAFT D L,HONG T S,SHIH H A,et al.Improved planning time and plan quality through multi-criteria optimization for intensity-modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2012,82(1):83-90.
[23]CRAFT D,RICHTER C.Deliverable navigation for multicriteria step and shoot IMRT treatment planning[J].Phys Med Biol,2013,58(1):87-103.
[24]HU W,WANG J,LI G,et al.Investigation of plan quality between RapidArc and IMRT for gastric cancer based on a novel beam angle and multicriteria optimization technique[J].Radiother Oncol,2014,111(1):144-147.
[25]FEUVRET L,NO?L G,MAZERON J J,et al.Conformity index:a review[J].Int J Radiat Oncol Biol Phys,2006,64(2):333-342.
[26]OOZEER R,CHAUVET B,GARCIA R,et al.Dosimetric evaluation of conformal radiotherapy:conformity factor[J].Cancer Radiother,2000,4(3):207-216.