| Zheng Wanjia,Li Enting,Huang Sijuan,Zhu Yunting,Lian Jinxing,Wang Mingli,Huang Xiaoyan,Yang Xin.Dosimetric effects of volumetric modulated arc therapy plans for lung cancer caused by different dose algorithms and radiation field settings[J].Chinese Journal of Radiological Medicine and Protection,2022,42(9):671-677 |
| Dosimetric effects of volumetric modulated arc therapy plans for lung cancer caused by different dose algorithms and radiation field settings |
| Received:May 04, 2022 |
| DOI：10.3760/cma.j.cn112271-20220504-00187 |
| KeyWords:Lung cancer Volume modulated arc therapy Irradiation field setting Dose calculation algorithms Dose difference analysis |
| FundProject:广东省基础与应用基础研究基金(2021A1515220140);中山大学肿瘤防治中心“青年优创”计划(QNYCPY32);肿瘤精准放疗登峰计划(2021-DF-009);肿瘤精准放疗星火计划(2019-N-11-34) |
| Author Name | Affiliation | E-mail | | Zheng Wanjia | Department of Oncology, Southern Theater Air Force Hospital of the People's Liberation Army, Guangzhou 510050, China | | | Li Enting | Department of Biomedical Engineering, Guangzhou Xinhua College, Guangzhou 510520, China | | | Huang Sijuan | Department of Radiotherapy, Sun Yat-sen University Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine
Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060 | | | Zhu Yunting | Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China | | | Lian Jinxing | Department of Radiotherapy, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, China | | | Wang Mingli | Department of Radiotherapy, Sun Yat-sen University Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine
Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060 | | | Huang Xiaoyan | Department of Radiotherapy, Sun Yat-sen University Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine
Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060 | | | Yang Xin | Department of Radiotherapy, Sun Yat-sen University Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine
Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060 | yangxin@sysucc.org.cn |
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| Abstract:: |
| Objective To analyze the dosimetric differences of volumetric modulated arc therapy (VMAT) plans for lung cancer caused by different dose calculation algorithms and radiation field settings and thus to provide a reference for designing clinical VMAT plans for lung cancer.Methods This study randomly selected 20 patients with lung cancer and divided them into four groups of VMAT plans,namely,a group adopting two fields and two arcs based on the AAA algorithm (2F2A_AAA),a group employing two fields and two arcs based on the AXB algorithm (2F2A_AXB),a group using two fields and two arcs based on the MC algorithm (2F2A_MC),and a group adopting one field and two arcs based on the MC algorithm (1F2A_MC).Then,this study evaluated the target coverage,high-dose control,dose homogeneity index (HI),conformity index (CI),and organs at risk (OARs) of the plans using different algorithms and radiation field settings.Results The planning target volume (PTV) results of two fields combined with two arcs (2F2A) of three groups using different algorithms are as follows.2F2A_MC achieved better results in both D1% and V95%(the relative volume of the target volume surrounded by 95% of the prescribed dose) of planning gross target volume (PGTV) than 2F2A_AAA (D1%:t=-2.44,P=0.03;V95%:z=-2.04,P=0.04) and 2F2A_AXB (D1%:t=2.34,P=0.03;z=-3.21,P < 0.01).2F2A_AXB outperformed 2F2A_AAA (z=-3.66,P < 0.01) and was comparable to 2F2A_MC in terms of the CI of PGTV.Regarding OARs,2F2A_AXB and 2F2A_MC decreased the V5 Gy of the whole lung by 0.68%(z=-2.69,P=0.01) and 3.05%(z=-3.52,P < 0.01),respectively compared to 2F2A_AAA.2F2A_AXB achieved a whole-lung Dmean of 1776.44 cGy,which was superior to that of 2F2A_MC (t=2.67,P=0.02) and 2F2A_AAA (t=8.62,P < 0.01).Compared to 2F2A_AAA and 2F2A_MC,2F2A_AXB decreased the V20 Gy of Body_5 mm by 1.45%(z=-3.88,P < 0.01) and 2.01%(z=-3.66,P < 0.01),respectively.The results of the two groups with different field settings showed that 1F2A_MC was superior to 2F2A_MC in both the CI of PTV1 and the HI of PTV2(CI:t=2.61,P=0.02;HI:z=-2.20,P=0.03).Moreover,1F2A_MC increased the Dmean of the whole lung by 26.29 cGy compared to 2F2A_MC (t=2.28,P=0.04).Conclusions Regarding the design of VMAT plans for lung cancer,the MC algorithm is suitable for the target priority and the AXB algorithm is suitable for the OAR priority.When only the MC algorithm is available,it is recommended to choose 1F2A in the case of target priority and select 2F2A in the case of OAR priority. |
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