| 于超俊,李博,韦珍珍,等.空腔校正对鼻咽癌调强放疗计划优化收敛偏差的影响[J].中华放射医学与防护杂志,2026,46(6):573-580.Yu Chaojun,Li Bo,Wei Zhenzhen,et al.Effects of air cavity correction on optimization convergence errors in intensity-modulated radiation therapy planning for nasopharyngeal carcinoma[J].Chin J Radiol Med Prot,2026,46(6):573-580 |
| 空腔校正对鼻咽癌调强放疗计划优化收敛偏差的影响 |
| Effects of air cavity correction on optimization convergence errors in intensity-modulated radiation therapy planning for nasopharyngeal carcinoma |
| 投稿时间：2025-10-28 |
| DOI：10.3760/cma.j.cn112271-20251028-00380 |
| 中文关键词: 空腔校正|鼻咽癌|调强放疗|优化收敛偏差 |
| 英文关键词:Air cavity correction|Nasopharyngeal carcinoma|Intensity-modulated radiation therapy|Optimization convergence error |
| 基金项目:广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20250381,Z-A20250390) |
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| 中文摘要: |
| 目的 研究空腔校正对鼻咽癌调强放疗(IMRT)计划优化收敛偏差(OCE)的影响,为鼻咽癌精确放疗提供依据。方法 回顾性选取广西医科大学第一附属医院鼻咽癌放疗患者20例,基于Eclipse TPS分别开启空腔校正(ACCon)和关闭空腔校正(ACCoff)完成两组9野IMRT计划,在原发灶计划靶区内以CT值-100 HU为阈值分别生成空腔靶区和组织靶区,评估3个靶区和危及器官(OARs)的剂量学以及计划复杂性参数,并分析空腔占比与两组计划间参数差值的相关性。结果 ACCon组3个靶区的Dmin、D95%和V100%高于ACCoff组(t=2.60、9.70、8.32,3.04、3.79、7.16,2.75、2.17、2.77,P<0.05),空腔靶区的V100%提高了21.68%[(84.97%±4.98%)vs.(69.83%±8.03%)];计划靶区和组织靶区的Dmax和均匀性指数(HI)低于ACCoff组(t=-2.69、-4.58,-2.69、-2.57,P<0.05),组织靶区的HI降低了15.68%[(0.086±0.006)vs. (0.102±0.027)]。OARs的Dmax和计划复杂性参数差异无统计学意义(P＞0.05)。空腔占比与两组计划间的计划靶区ΔDmin、ΔD95%、ΔV100%呈正相关性(r=0.69、0.82、0.66,P<0.05),与ΔHI呈负相关性(r=-0.50,P<0.05)。结论 开启空腔校正优化鼻咽癌IMRT计划,可改善OCE、增加空腔靶区剂量、提高计划靶区剂量覆盖和均匀性,且不增加OARs剂量和计划复杂性。空腔占比越大,空腔校正优化对于改善OCE效果越显著。 |
| 英文摘要: |
| Objective To investigate the effects of air cavity correction (ACC) on optimization convergence errors (OCEs) in intensity-modulated radiation therapy (IMRT) planning for nasopharyngeal carcinoma (NPC) and to provide a basis for precise radiotherapy of NPC. Methods A retrospective study was conducted on 20 NPC patients treated at the First Affiliated Hospital of Guangxi Medical University. Two groups of 9-field IMRT plans were designed for these patients using the Eclipse treatment planning system (TPS): one with ACC turned on (the ACCon group) and the other with ACC turned off (the ACCoff group). A planning target volume (PTV) of the primary tumor was segmented into two sub-volumes based on a HU threshold of -100 in the computed tomography (CT) scans: a cavity-containing target volume (< -100 HU) and a tissue-containing target volume (CT > -100 HU). The dosimetric parameters of three target volume types and organs at risk (OARs), as well as plan complexity were assessed. Additionally, the correlations between the proportion of air cavity volume and the parameter differences between the two plan groups were analyzed. Results The ACCon group exhibited higher Dmin, D95%, and V100% of the three target volume types than the ACCoff group (t =2.60, 9.70, 8.32,3.04, 3.79, 7.16,2.75, 2.17, 2.77, P < 0.05), with the V100% of cavity-containing target volumes increasing by 21.68% ［(84.97% ±4.98%) vs. (69.83% ±8.03%)］. In contrast, the ACCon group showed lower Dmax and homogeneity index (HI) of PTVs and tissue-containing target volumes than the ACCoff group (t =-2.69,-4.58,-2.69、-2.57, P< 0.05), with the HI of the tissue-containing target volumes decreasing by 15.68%［(0.102 ±0.027)vs.(0.086 ±0.006)］. No statistically significant differences in the Dmax of OARs and plan complexity were observed between both groups (P > 0.05). Correlation analysis reveals positive correlations between the proportion of cavity volume and the ΔDmin, ΔD95%, and ΔV100% of PTVs between both groups (r = 0.69, 0.82, 0.66, P< 0.05) and a negative correlation between the proportion of air cavity volume and ΔHI between both groups (r = -0.50, P< 0.05). Conclusions The ACC-based optimization of IMRT planning for NPC can significantly reduce OCEs, enhance dose delivered to air cavities, and improve the dose coverage and uniformity to PTVs without compromising OARs sparing or increasing plan complexity. Notably, a larger proportion of the cavity volume corresponds to a more significant optimization effect of ACC in reducing OCEs. |
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