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基于预测可行性DVH的肝癌VMAT自动计划方法研究
韩飞, 夏文龙, 马攀, 任雯廷, 陈佳赟, 门阔, 陈波, 戴建荣
国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
An automatic VMAT planning method for primary liver cancer radiotherapy based on predicting the feasibility DVH
Han Fei, Xia Wenlong, Ma Pan, Ren Wenting, Chen Jiayun, Men Kuo, Chen Bo, Dai Jianrong
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To establish an automatic planning method using volumetric-modulated arc therapy (VMAT) for primary liver cancer (PLC) radiotherapy based on predicting the feasibility dose-volume histogram (DVH) and evaluate its performance. Methods Ten patients with PLC were randomly chosen in this retrospective study. Pinnacle Auto-Planning was used to design the VMAT automatic plan, and the feasibility DVH curve was obtained through the PlanIQ dose prediction, and the initial optimization objectives of the automatic plan were set according to the displayed feasible objectives interval. The plans were accessed according to dosimetric parameters of the planning target volume and organs at risk as well as the monitor units. All patients′ automatic plans were compared with clinically accepted manual plans by using the paired t-test. Results There was no significant difference of the planning target volume D2%, D98%, Dmean or homogeneity index between the automatic and manual plans ((58.55±2.81) Gy vs.(57.98±4.17) Gy,(47.15±1.58) Gy vs.(47.82±1.38) Gy,(53.14±0.95) Gy vs.(53.44±1.67) Gy and 1.15±0.05 vs. 1.14±0.07, all P>0.05). The planning target volume conformity index of the manual plan was slightly higher than that of the automatic plan (0.77±0.08 vs. 0.69±0.06, P<0.05). The mean doses of normal liver, V30Gy, V20Gy, V10Gy, V5Gy and V<5Gy of the automatic plan were significantly better than those of the manual plan ((26.68±11.13)% vs.(28.00±10.95)%,(29.96±11.50)% vs.(31.89±11.51)%,(34.88±11.51)% vs.(38.66±11.67)%,(45.38±12.40)% vs.(50.74±13.56)%, and (628.52±191.80) cm3vs.(563.15±188.39) cm3, all P<0.05). The mean doses of the small intestine, the duodenum, and the heart, as well as lung V10 of the automatic plan were significantly less than those of the manual plan ((1.83±2.17) Gy vs.(2.37±2.81) Gy,(9.15±9.36) Gy vs.(11.18±10.49) Gy,and (5.44±3.10) Gy vs.(6.25±3.26) Gy, as well as (12.70±7.08)% vs.(14.47±8.11)%, all P<0.05). Monitor units did not significantly differ between two plans ((710.67±163.72) MU vs.(707.53±155.89) MU, P>0.05). Conclusions The automatic planning method using VMAT for PLC radiotherapy based on predicting the feasibility DVH enhances the quality for PLC plans, especially in terms of normal liver sparing. Besides, it also has advantages for the protection of the intestine, whole lung and heart.
Han Fei,Xia Wenlong,Ma Pan et al. An automatic VMAT planning method for primary liver cancer radiotherapy based on predicting the feasibility DVH[J]. Chinese Journal of Radiation Oncology, 2021, 30(8): 797-802.
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