基于预测可行性DVH的肝癌VMAT自动计划方法研究

doi:10.3760/cma.j.cn113030-20210501-00183

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

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) cm³ vs.(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.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Han Fei
	Xia Wenlong
	Ma Pan
	Ren Wenting
	Chen Jiayun
	Men Kuo
	Chen Bo
	Dai Jianrong

Key words： Liver neoplasm/volumetric-modulated arc therapy Automatic planning Dose-volume histogram

Received: 01 May 2021

Corresponding Authors: Dai Jianrong, Email:dai_jianrong@cicams.ac.cn.

Cite this article:

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.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20210501-00183 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I8/797

[1] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132. DOI:10.3322/caac.21338.
[2] Forner A, Reig ME, de Lope CR, et al. Current strategy for staging and treatment:the BCLC update and future prospects[J]. Semin Liver Dis, 2010, 30(1):61-74. DOI:10.1055/s-0030-1247133.
[3] Yamamoto M, Takasaki K, Otsubo T, et al. Favorable surgical outcomes in patients with early hepatocellular carcinoma[J]. Ann Surg, 2004, 239(3):395-399. DOI:10.1097/01.sla.0000114215.03112.e0.
[4] Liang SX, Zhu XD, Xu ZY, et al. Radiation-induced liver disease in three-dimensional conformal radiation therapy for primary liver carcinoma:the risk factors and hepatic radiation tolerance[J]. Int J Radiat Oncol Biol Phys, 2006, 65(2):426-434. DOI:10.1016/j.ijrobp.2005.12.031.
[5] 罗政,饶建,殷蔚伯. 放疗在原发性肝癌治疗中地位和现状[J]. 中华放射肿瘤学杂志,2006, 15(4):345-346. DOI:DOI:10.3760/j.issn:1004-4221.2006.04.033.
Luo Z, Rao J, Yin WB. The status and position of radiotherapy in the treatment of primary liver cancer[J]. Chin J Radiat Oncol, 2006, 15(4):345-346. DOI:DOI:10.3760/j.issn:1004-4221.2006.04.033.
[6] 巩贯忠,尹勇,刘同海,等. RapidArc进行肝癌放疗时不同靶区确定方法的剂量学比较[J]. 中华放射医学与防护杂志,2012, 32(3):289-293. DOI:10.3760/cma.j.issn.0254-5098.2012.03.017.
Gong GZ, Yin Y, Liu TH, et al. Dosimetric differences among RapidArc plans based on different target volumes in radiotherapy of hepatocelluar carcinoma[J]. Chin J Radiol Med Prot, 2012, 32(3):289-293. DOI:10.3760/cma.j.issn.0254-5098.2012.03.017.
[7] Zeng ZC, Jiang GL, Wang GM, et al. DNA-PKcs subunits in radiosensitization by hyperthermia on hepatocellular carcinoma hepG2 cell line[J]. World J Gastroenterol, 2002, 8(5):797-803. DOI:10.3748/wjg.v8.i5.797.
[8] 伍艳玲,冯勤付. 原发性肝细胞肝癌手术联合放疗的进展[J]. 中华放射医学与防护杂志,2019, 39(7):554-557. DOI:10.3760/cma.j.issn.0254-5098.2019.07.014.
Wu YL, Feng QF. Progress of surgery combined with radiotherapy for primary hepatocellular carcinoma[J]. Chin J Radiol Med Prot, 2019, 39(7):554-557. DOI:10.3760/cma.j.issn.0254-5098.2019.07.014.
[9] 张国前,张书旭,王锐濠, 等. Auto-planning在脑胶质瘤非共面容积调强放疗计划中的应用[J]. 中国医学物理学杂志, 2018, 35(5):514-518. DOI:10.3969/j.issn.1005-202X.2018.05.004.
Zhang GQ, Zhang SX, Wang RH, et al. Application research on auto-planning in non-coplanar VMAT plan for brain gliomas[J]. Chin J Med Phys, 2018, 35(5):514-518. DOI:10.3969/j.issn.1005-202X.2018.05.004.
[10] 曾广平,康盛伟, 唐斌,等. Pinnacle计划系统自动与手动容积弧形调强计划剂量学比较[J]. 中国医疗设备,2019, 34(10):59-63. DOI:10.3969/j.issn.1674-1633.2019.10.016.
Zeng GP, Kang SW, Tang B, et al. Dosimetry comparison between automated and manual volumetric modulated arc therapy planning in pinnacle treatment planning system[J]. Chin Med Dev, 2019, 34(10):59-63. DOI:10.3969/j.issn.1674-1633.2019.10.016.
[11] 王继平,杨志勇,陈传喜,等. 基于Pinnacle³自动化计划设计模块在直肠癌调强放疗的应用研究[J]. 中华放射医学与防护杂志,2019, 39(4):285-289. DOI:10.3760/cma.j.issn.0254-5098.2019.04.008.
Wang JP, Yang ZY, Chen CX, et al. A dosimetric study of automated intensity-modulated radiotherapy planning for rectal cancer patients based on Pinnacle³ system[J]. Chin J Radiol Med Prot, 2019, 39(4):285-289. DOI:10.3760/cma.j.issn.0254-5098.2019.04.008.
[12] Hansen CR, Bertelsen A, Hazell I, et al. Automatic treatment planning improves the clinical quality of head and neck cancer treatment plans[J]. Clin Translat Radiat Oncol, 2016, 1:2-8. DOI:10.1016/j.ctro.2016.08.001.
[13] 张艺宝,蒋璠,岳海振,等. 利用VMAT模型基于知识IMRT计划半自动优化[J]. 中华放射肿瘤学杂志,2017, 26(2):178-181. DOI:10.3760/cma.j.issn.1004-4221.2017.02.012.
Zhang YB, Jang F, Yue HZ, et al. Knowledge-based semi-automated optimization of intensity-modulated radiotherapy plans using a volume modulated arc therapy-configured model[J]. Chin J Radiat Oncol, 2017, 26(2):178-181. DOI:10.3760/cma.j.issn.1004-4221.2017.02.012.
[14] Fogliata A, Wang PM, Belosi F, et al. Assessment of a model based optimization engine for volumetric modulated arc therapy for patients with advanced hepatocellular cancer[J]. Radiat Oncol, 2014, 9:236. DOI:10.1186/s13014-014-0236-0.
[15] Fried DV, Chera BS, Das SK. Assessment of PlanIQ Feasibility DVH for head and neck treatment planning[J]. J Appl Clin Med Phys, 2017, 18(5):245-250. DOI:10.1002/acm2.12165.
[16] Perumal B, Sundaresan HE, Ranganathan V, et al. Evaluation of plan quality improvements in PlanIQ-guided Autoplanning[J]. Rep Practi Oncolo Radiother, 2019, 24(6):533-543. DOI:10.1016/j.rpor.2019.08.003.
[17] Xia W, Han F, Chen J, et al. Personalized setting of plan parameters using feasibility dose volume histogram for auto-planning in Pinnacle system[J]. J Appl Clin Med Phys, 2020, 21(7):119-127. DOI:10.1002/acm2.12897.
[18] 张黎,习勉,孙文钊,等. 肝癌三维适形、静态调强与容积旋转调强放射治疗的剂量学研究[J]. 中山大学学报(医学科学版),2012, 33(3):402-406.
Zhang L, Xi M, Sun WZ, et al. Dosimetric comparison of 3DCRT, static IMRT, and VMAT for hepatocellular carcinoma[J]. J Sun Yat-sen Univ (Med Sci), 2012, 33(3):402-406.