Zhang Jianping,Wang Lin,Xu Benhua,Huang Miaoyun,Chen Yuangui,Li Wenyao,Li Xiaobo.Effects of the new conformity index on planning quality of lung cancer SBRT[J].Chinese Journal of Radiological Medicine and Protection,2018,38(6):424-428
Effects of the new conformity index on planning quality of lung cancer SBRT
Received:December 01, 2017  
DOI:10.3760/cma.j.issn.0254-5098.2018.06.005
KeyWords:Peripheral lung cancer  Stereotactic body radiation therapy  Conventional conformity index  New conformity index
FundProject:福建省医学创新项目(2016-CX-19)
Author NameAffiliationE-mail
Zhang Jianping Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Wang Lin Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Xu Benhua Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Huang Miaoyun Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Chen Yuangui Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Li Wenyao Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China  
Li Xiaobo Department of Radiation Oncology, Fujian Medical University Union Hospital, Cyberknife Center, Fujian Medical University Union Hospital, Fuzhou 350001, China lixiaobo2004@126.com 
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Abstract::
      Objective To analyze the effect of the new conformal index (nCI) and the conventional conformal index (CI) on the treament planning quality of lung stereotopic radiotherapy (SBRT). Methods A total of 19 peripheral lung cancer patients, treated with SBRT in Fujian Medical University Union Hospital from 2014 to 2017, were analyzed retrospectively. Each patient was planned twice yielding identical CI and nCI. The prescription to 95% of planning target volume (PTV) was 48 Gy in four fractions, and renormalization was performed when needed for nineteen nCI plans. The Wilcoxon signed-rank test was used to examine the dosimetric index. Results The dose conformity plots indicate that nCI does not only reflect the dose to the organ at risk outside tumor, but also represents the dose distribution in the PTV. In addition, nCI was stricter with treatment planning qualities when the dose around PTV was closer to the prescribed dose. The value of target coverage (TC), the ratio of out-of-target volumes receiving 105% prescribed dose to the target volume (R105%), the ratio of volume covered by 50% isodose line to the target volume (R50%), and the ipsilateral lung V20 were 98.70%, 0.56, 5.53, 15.59% in the CI plans, vs. 90%, 0, 4.99, 14.42% in the corresponding nCI plans, respectively. All index were significantly lower in the nCI group (Z=-3.823, -3.180, -3.823, -3.783, respectively, P<0.05). The ratio of the maximum dose to the 2 cm external margin from the PTV (D2 cm) to the maximum dose to the PTV were 63.70% and 64.07% respectively in the two groups, and the differences were not statistially significant (P>0.05). The conformity values denoted a clinically favorable value as 1 between D95% and D99% of nCI plans, yet were not applicable to CI plans. Conclusions It is more clinically relavant to evaluate lung SBRT plans using nCI, TC and other indicators collectively than using CI alone.
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