目的:比较和分析基于Monaco和Pinnacle这两种计划设计系统设计宫颈癌放疗容积旋转调强(VMAT)计划的剂量差异,探寻更适用于宫颈癌VMAT计划设计的计划设计系统.方法:选取11例在云南省肿瘤医院接受根治性放射治疗的宫颈癌病人.在定位CT数据、靶区和危及器官完全一致的前提下,分别基于Monaco系统和Pinnacle系统为病人设计VMAT计划,即VMATMONACO和VMATPINNACLE.比较两个计划中靶区的剂量分布、适形指数、均匀性指数及危及器官的剂量体积差异,探讨两种TPS在设计宫颈癌根治放疗VMAT计划中的优劣,以及产生这种优劣的原因.结果:就PGTVnd和PTV的适形指数而言,VMATMONACO和VAMTPINNACLE计划的差异不具有统计学意义(P>0.05).就PGTVnd的均匀性指数而言,VMATPINNACLE优于VMATMONACO,差异具有统计学意义(P<0.05).VMATMONACO和VMATPINNACLE在直肠、膀胱的低剂量区不存在差异(P>0.05);在高剂量区域,VMATMONACO显现出优于VMATPINNACLE的趋势;在直肠和膀胱的平均剂量上,VMATMONACO明显低于VMATPINNACLE,差异具有显著统计学意义(P<0.01).VMATMONACO的小肠和股骨头的剂量明显低于VMATPINNACLE,差异具有显著统计学意义(P<0.05).结论:宫颈癌VMAT计划中,相较Pinnacle系统,选用Monaco系统设计放疗计划存在潜在的剂量学优势.%Objective To compare and analyze the dose differences of volumetric modulated arc radiotherapy (VMAT) plan for cervical cancer based on Monaco treatment planning system (TPS) and Pinnacle TPS for exploring an optimal TPS to design cervical cancer VMAT plan. Methods Eleven cervical cancer patients receiving radical radiotherapy in Yunnan Tumor Hospital were selected. With the same location CT data, target areas and organs-at-risk, Monaco TPS and Pinnacle TPS were applied to design two VMAT plans for each patient, namely VMATMONACOplan and VMATPINNACLEplan. The dose distribution in target areas, conformity index, homogeneity index, and the dose-volume differences in organs-at-risk were compared. Finally, the advantage and disadvantage of two kinds of TPS in VMAT plan design were discussed and their causes were expounded. Results The differences in conformity index of PGTVnd and PTV didn't showed any significances between VMATMONACOplan and VMATPINNACLEplans (P>0.05). For the homogeneity index of PGTVnd, VMATPINNACLEplan was superior to VMATMONACOplan, with statistical differences (P<0.05). No differences were found in the low-dose area of the rectum and bladder between VMATPINNACLEplan and VMATVMATplan (P>0.05); in high-dose areas, VMATMONACOplan was better than VMATPINNACLEplan. The mean doses of the rectum and the bladder in VMATMONACOplan were lower than those in VMATPINNACLEplan, with statistical significance (P<0.01). Moreover, the dose of the small intestine and the femur head were lower in VMATMONACOplan as compared with VMATPINNACLEplan (P<0.05). Conclusion Using Monaco TPS instead of Pinnacle TPS to design radiotherapy plan for cervical cancer has potential dose advantages.
展开▼
