| 程志垚,李定杰,吴慧,黄蓉,尹小芳,王枫.MdaccAutoPlan软件在鼻咽癌调强放疗计划设计的应用分析[J].中华放射医学与防护杂志,2018,38(4):285-290 |
| MdaccAutoPlan软件在鼻咽癌调强放疗计划设计的应用分析 |
| Clinical application of MdaccAutoPlan in the planning of nasopharyngeal carcinoma with intensity modulated radiotherapy |
| 投稿时间：2017-09-09 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.04.008 |
| 中文关键词: MdaccAutoPlan 调强放疗 计划设计 |
| 英文关键词:MdaccAutoPlan Intensity modulated radiotherapy Treatment planning |
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| 中文摘要: |
| 目的 比较MdaccAutoPlan软件与人工计划设计在鼻咽癌调强放疗的应用价值。方法 选取20例鼻咽癌初治患者，应用MdaccAutoPlan软件设计自动治疗计划（MDAP）与人工计划，在保证射野角度、优化参数、计划要求等条件尽量一致的情况下，对两种计划进行计划评价剂量学以及工作效率方面数据的对比。结果 MDAP中PGTV、PTV1、PTV2的D98%、Dmean较人工计划降低2.5%、0.3%、0.1%、0.5%、0.6%、1.0%，PGTV、PTV1、PTV2的D2%较人工计划上升1.7%、1.5%、0.6%。其中PGTV D98%、PGTV D2%和PTV2 D98%两组比较，差异有统计学差异（t=5.519、6.701、0.937，P<0.05）。MDAP的右侧腮腺D50%、左侧腮腺D50%、脊髓Dmax、脊髓Dmean较人工计划减少24.8%、27.7%、11.4%、14.0%，两组比较，差异有统计学意义（t=5.447、5.375、6.786、3.810，P<0.05），两侧眼晶状体较人工计划升高65.0%、19.3%，两组比较差异有统计学意义（t=9.863、3.440，P<0.05）。视神经、视交叉和脑干3种危及器官的剂量学比较，差异均无统计学意义（P>0.05）。MDAP的后颈部剂量分布略优于人工计划，剂量体积直方图（DVH）中，人工计划的计划靶区曲线、脑干曲线、脊髓曲线均高于MDAP。MDAP计划的人工操作时间较人工计划减少了59.4%，计算机处理时间较人工计划增加了34.4%。结论 MdaccAutoPlan软件对鼻咽癌放射治疗有一定的临床应用价值，危及器官剂量限制可能优于人工计划，且能减少计划设计时间，提高计划效率。 |
| 英文摘要: |
| Objective To compare the MdaccAutoPlan (MDAP)software with Manual planning in intensity modulated radiotherapy (IMRT) planning for nasopharyngeal carcinoma (NPC) patients. Methods A total of 20 newly diagnosed NPC patients were enrolled and their IMRT plans were designed with MDAP software and manually, respectively with identical field angle, optimization parameters and other planning requirements. Dosimetric differences and planning efficiency were compared for these two planning method. Results The PGTV D98%, PGTV Dmean, PTV1 D98%, PTV1 Dmean, PTV2 D98%, PTV2 Dmean of plans generated from MDAP were reduced by 2.5%, 0.3%, 0.1%, 0.5%, 0.6%, 1.0%, respectively, compared with those in plans generated manually. The D2%of the PGTV, PTV1, PTV2 in MDAP plans were increased by 1.7%, 1.5%, 0.6% compared with those in manual plans, respectively. There were significant differences observed in the PGTV D98%, PGTV D2% and PTV2 D98% between these two planning method (t=5.519, 6.701, 0.937, P<0.05).The D50% of right parotidand left parotid, the Dmax, and Dmean of the spinal cord in MDAP plans were reduced significantly by 24.8%, 27.7%, 11.4%, 14.0%, respectively, compared with those in manual plans (t=5.447, 5.375, 6.786, 3.810, P<0.05). The dose of both lens increased significantly by 65.0% and 19.3%, respectively, in MDAP plans compared with Manual plans (t=9.863, 3.440, P<0.05). There was no significant dosimetric difference observed in opticnerve, opticchiasm and brainstem between these two planning method. The dose distribution of post neck in MDAP plans were better than those in manual plans.The dose-volume histogram curves of planning target volume, brainstem and spial cord in the manul plans were higher than those in the MDAP plans. The labor time of MDAP planning was reduced by 54.4% compared with Manual planning, while computer working time was increased by 34.4% with MDAP planning compared with Manual planning. Conclusions MDAP planning is clinically valualbe in its applicaion for a NPC IMRT planning with a better sparing for OARs, a decreased planning time and improvement on planning efficiency compared with manual planning. |
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