| Ying Shao,Fuli Zhang,Shi Wang,Weidong Xu,Jing Jiang. Estimation of the effect of target and normal tissue sparing based on equivalent uniform dose-based optimization in hypofractionated radiotherapy for lung cancer. Oncol Transl Med, 2019, 5: 197-203. |
| 基于等效均匀剂量优化算法对肺癌大分割放疗中靶区和正常组织的影响评估 |
| Estimation of the effect of target and normal tissue sparing based on equivalent uniform dose-based optimization in hypofractionated radiotherapy for lung cancer |
| Received:June 14, 2019 Revised:November 13, 2019 |
| DOI：10.1007/s10330-019-0364-4 |
| 中文关键词: 非小细胞肺癌；等效均匀剂量；大分割放疗；计划优化 |
| 英文关键词: non-small cell lung cancer (NSCLC); equivalent uniform dose (EUD); hypofractionated radiotherapy; plan optimization |
| 基金项目:首都临床特色应用研究专项课题“基于多模态影像的非小细胞肺癌精确放疗SAAS平台研究”（课题编号：Z181100001718011） |
| Author Name | Affiliation | Postcode | | Ying Shao | Deparment of Radiotherapy, The Seventh Medical Center, PLA General Hospital/Beijing Tsinghua Changgeng Hospital affiliated to Tsinghua University | 102218 | | Fuli Zhang* | Department of Radiotherapy, The Seventh Medical Center, PLA General Hospital | 100700 | | Shi Wang | Department of Engineering Physics, Tsinghua University | 100084 | | Weidong Xu | Department of Radiotherapy, The Seventh Medical Center, PLA General Hospital | 100700 | | Jing Jiang | Deparment of Radiotherapy, The Seventh Medical Center, PLA General Hospital/Beijing Tsinghua Changgeng Hospital affiliated to Tsinghua University | 102218 |
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| 中文摘要: |
| 目的：探讨基于剂量-体积（dose-volume,DV）函数与等效均匀剂量（equivalent uniform dose, EUD）函数计划优化方法在肺癌大分割放疗中的剂量学差异。方法：选择已接受放疗的10例非小细胞肺癌病例，分别对每个病例使用DV优化、DV+EUD优化、EUD+DV优化及EUD优化方法重新设计VMAT治疗计划。计算、统计多项剂量学参数以评估4种优化方法在肺癌大分割放疗中的剂量学差异。结果：就靶区而言，EUD优化与EUD+DV优化组的EUD值接近，两组的EUD值比另两组EUD值分别高2.8%～3.6%和 3.2%~3.7%；计算获得的EUD和EUD+DV优化组的肿瘤控制概率（tumor control probability,TCP）平均值也比DV和DV+EUD优化组高，差异有统计学意义（P<0.05）。靶区均匀性指数（heterogeneity index, HI）差异有统计学意义（P<0.05），而均匀性指数（conformity index, CI）差异无统计学意义（P>0.05）。就危及器官（organs at risk, OARs）而言，正常肺组织的EUD、V5、V10、V20、V30以及心脏与脊髓的剂量参数差异均无统计学意义（P>0.05）。结论：基于EUD的优化方法提高靶区的EUD与TCP值和保护正常肺组织方面具有优势，在临床工作中可作为选择计划优化方法的剂量学参考依据。 |
| 英文摘要: |
| Objective This study aims to investigate the dosimetric differences among four planning methods of
physical and biological optimization in hypofractionated radiation therapy for non-small cell lung cancer
(NSCLC).
Methods Ten NSCLC patients receiving radiation therapy were chosen for this retrospective study.
Volumetric modulated arc treatment plans for each patient were remade with dose-volume (DV) functions,
biological-physical functions, and biological functions, using the same constraint parameters during
optimization. The dosimetric differences between the four types of plans were calculated and analyzed.
Results For the target, equivalent uniform dose (EUD) of the EUD and EUD + DV groups was
approximately 2.8%–3.6% and 3.2%–3.7% higher than those of the DV and DV + EUD groups, respectively.
The average tumor control probability (TCP) of the EUD and EUD + DV groups was also significantly higher
than those of the other two groups (P < 0.05). The difference in heterogeneity index (HI) among the four
groups was also statistically significant (P < 0.05), while the difference of conformity index (CI) was not
significant (P > 0.05). For the organs at risk, the differences of EUD, V5, V10, V20, V30 of normal lung tissues
were not statistically significant (P > 0.05); however, the mean lung dose of the EUD and EUD + DV groups
was slightly lower than those of the other two groups.
Conclusion The biological optimization method has obvious advantages of improving EUD and TCP of
the target, while decreasing the exposed dose of normal lung. This result is meaningful in choosing plan
optimization methods in routine work. |
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