张麒麟,王明清,张书铭,庄洪卿,江萍,曲昂,姜伟娟,王皓,杨瑞杰.基于先验知识的宫颈癌自动计划模型泛化的可行性研究[J].中华放射医学与防护杂志,2021,41(5):327-333
基于先验知识的宫颈癌自动计划模型泛化的可行性研究
The feasibility study of generalization of knowledge-based planning for cervical cancer
投稿时间:2020-12-04  
DOI:10.3760/cma.j.issn.0254-5098.2021.05.002
中文关键词:  放射治疗  自动计划  宫颈癌
英文关键词:Radiotherapy  Automatic planning  Cervical cancer
基金项目:国家自然科学基金(81071237,81372420);北京市自然科学基金(7202223);首都卫生发展科研专项(2020-2Z-40919);北京市科学技术委员会协同创新项目(Z201100005620012)
作者单位E-mail
张麒麟 北京大学第三医院肿瘤放疗科 100191  
王明清 北京大学第三医院肿瘤放疗科 100191  
张书铭 北京医院超声医学科 100730  
庄洪卿 北京大学第三医院肿瘤放疗科 100191  
江萍 北京大学第三医院肿瘤放疗科 100191  
曲昂 北京大学第三医院肿瘤放疗科 100191  
姜伟娟 北京大学第三医院肿瘤放疗科 100191  
王皓 北京大学第三医院肿瘤放疗科 100191  
杨瑞杰 北京大学第三医院肿瘤放疗科 100191 ruijyang@yahoo.com 
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中文摘要:
      目的 设计一种基于先验知识的宫颈癌自动计划模型并将其应用于子宫内膜癌及直肠癌的病例,探讨模型的泛化性。方法 收集179例盆腔部位不同处方剂量下的双弧容积旋转调强放射治疗临床计划,其中处方剂量50.4 Gy的99例宫颈癌临床计划作为训练集建立RapidPlan模型,剩余80例临床计划分为4个验证组(处方剂量50.4 Gy的宫颈癌和子宫内膜癌临床计划各20例,为A、B组;处方剂量45 Gy的子宫内膜癌和直肠癌临床计划各20例,为C、D组),利用模型分别对4组中的临床计划进行重新优化设计并得到自动计划,对比自动计划与临床计划靶区(PTV)和危及器官(OAR)的剂量学参数。结果 A、B、C、D组中自动计划靶区的适形度指数(CI)与临床计划相当,且差异均无统计学意义(P>0.05)。A、B、C组中自动计划的均匀性指数(HI)和D2%均小于临床计划,且差异有统计学意义(HI:Z=-3.248、-3.360、-2.329,P<0.05;D2%Z=-2.987、-3.397、-2.442,P<0.05)。D组自动计划的HI和D2%与临床计划相当,且差异无统计学意义(P>0.05)。在保证PTV受量的同时,所有组中自动计划的OAR剂量学参数的平均值均低于临床计划。结论 由宫颈癌临床计划建立的RapidPlan模型能够完成对不同处方剂量下子宫内膜癌及直肠癌的自动计划设计,初步证明了RapidPlan模型泛化的可能性。
英文摘要:
      Objective To design a knowledge-based cervical cancer planning model and apply it to cases of endometrial cancer and rectal cancer in order to explore the generalization of the model. Methods A total of 179 cases of pelvic regions with different prescribed doses of dual-arc volumetric modulated arc therapy clinical plans were collected, of which 99 cases of cervical cancer clinical plans with a prescribed dose of 50.4 Gy were used as the training set to establish the RapidPlan model, and the remaining clinical plans were divided into 4 validation groups with 20 cases in each group. The clinical plans for cervical cancer and endometrial cancer with a prescription dose of 50.4 Gy were named groups A and B, while the clinical plan for endometrial cancer and rectal cancer with a prescription dose of 45 Gy were named groups C and D. The model was used to redesign the clinical plans in the 4 groups and the automatic plans were obtained. The planning target volume (PTV) and organ at risk (OAR) dosimetry parameters were compared between automatic plans and clinical plans. Results The conformity index (CI) of the automatic plans in the A, B, C, and D groups were equivalent to that of the clinical plans (P>0.05). The homogeneity index (HI) and D2% of the automatic plans in groups A, B, and C were all lower than those in clinical plans(HI, Z=-3.248, -3.360, -2.329,P<0.05;D2%,Z=-2.987, -3.397, -2.442,P<0.05). The HI and D2% of the automatic plans in group D were similar those in the clinical plans (P>0.05). While ensuring the PTV coverage, the average value of OAR dosimetry parameters in all automatic plans groups were lower than that of the clinical plans. Conclusions The RapidPlan model established by the cervical cancer clinical plans can complete the automatic plan design for endometrial cancer and rectal cancer under different prescription doses, which preliminarily proves the possibility of the generalization of the RapidPlan model.
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