| 桂龙刚,李军,石苗.Radixact螺旋断层放疗参数交互作用对鼻咽癌治疗效率的量化分析[J].中华放射医学与防护杂志,2026,46(8):755-762.Gui Longgang,Li Jun,Shi Miao.Quantifying the effects of parameter interactions on treatment efficiency in Radixact helical tomotherapy for nasopharyngeal carcinoma[J].Chin J Radiol Med Prot,2026,46(8):755-762 |
| Radixact螺旋断层放疗参数交互作用对鼻咽癌治疗效率的量化分析 |
| Quantifying the effects of parameter interactions on treatment efficiency in Radixact helical tomotherapy for nasopharyngeal carcinoma |
| 投稿时间：2026-02-06 |
| DOI：10.3760/cma.j.cn112271-20260206-00044 |
| 中文关键词: 鼻咽癌|Radixact|螺旋断层放疗|治疗效率|响应面法|参数优化 |
| 英文关键词:Nasopharyngeal carcinoma|Radixact|Helical tomotherapy|Treatment efficiency|Response surface methodology|Parameter optimization |
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| 中文摘要: |
| 目的 探讨鼻咽癌螺旋断层放疗中核心机器参数对执行效率的非线性影响规律,构建并验证基于响应面法(RSM)的耗时量化预测模型。方法 回顾性收集2025年9月至2025年11月在江苏省苏北人民医院接受螺旋断层放疗的10例鼻咽癌患者,在优先保障脑干、脊髓等危及器官(OARs)绝对安全的前提下,通过改变射野宽度、螺距及调制因子的组合,在 Radixact 计划系统中生成170个测试计划,经机械限制与剂量学双重筛选后,最终纳入147个有效计划。记录实际治疗时间、适形指数(CI)及均匀性指数(HI)等特征变量。采用多变量二次多项式拟合建立时间预测模型,并通过方差分析(ANOVA)评估参数的主效应与交互作用。结果 在严格的OARs剂量约束下,受解剖毗邻结构影响,各计划表现出合理的靶区剂量代偿(CI:1.03~1.18,HI:1.04~1.15,PTV均量偏差 < 1%)。在同等临床可接受质量下,不同参数组合导致的治疗时间范围为245.0~1752.0 s。回归模型拟合良好(R2>0.93)。方差分析显示,射野宽度、螺距及调制因子对治疗时间的主效应均有统计学意义(F = 182.61、64.80、51.33,P<0.01),且螺距与调制因子之间的交互作用亦有统计学意义(F = 12.71,P <0.01)。结论 螺旋断层放疗的机器耗时并非单参数的线性叠加。响应面量化模型可较好描述多参数间的非线性交互关系,有助于在保证靶区剂量质量的前提下提高参数选择效率,并为后续参数优化提供定量参考。 |
| 英文摘要: |
| Objective To explore the nonlinear effects of key machine parameters on treatment efficiency in helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC), in order to develop and verify a response surface method ology (RSM)-based quantitative prediction model for treatment time. Methods A total of 10 NPC patients treated at the Department of Radiation Oncology, Northern Jiangsu People's Hospital, were enrolled in this study. On the premise that the absolute safety of organs at risk (OARs), including the brainstem and spinal cord, was preferentially guaranteed, 170 test plans were generated using the Radixact system by changing the combinations of field width, pitch, and modulation factor. Based on mechanical constraints and dosimetric criteria, 147 valid plans were finally selected. The characteristic variables of the 147 plans, including actual treatment time, conformity index (CI), and homogeneity index (HI), were recorded. Then, a regression model for predicting treatment time was established through fitting using a multivariable quadratic polynomial. Furthermore, the main effects and interactions of the parameters were assessed through analysis of variance (ANOVA). Results Under strict constraints on doses to OARs and the influence of adjacent anatomical structures, all valid plans showed rational dose compensation in the target volumes (CI: 1.03-1.18; HI: 1.04-1.15; mean PTV dose deviations: < 1%). Under comparable clinically acceptable quality, the plans with varying parameter combinations exhibited treatment times ranging from 245.0 to 1752.0 s. The regression model exhibited encouraging fitting effects, with the coefficient of determination (R2) exceeding 0.93. ANOVA result revealed that the main effects of field width, pitch, and modulation factor on treatment time were all statistically significant (F = 182.61, 64.80, 51.33, P < 0.01). Furthermore, the difference of interaction between pitch and modulation factor was also statistically significant (F = 12.71, P < 0.01). Conclusions The treatment delivery time in helical tomotherapy is not a simple linear superposition of individual machine parameters. The RSM-based quantitative model enables the effective characterization of the nonlinear interactions among multiple parameters. This model can improve parameter selection efficiency while maintaining doses to target volumes and provide a quantitative reference for subsequent parameter optimization. |
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