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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Comparison of DVH parameters and loading patterns of standard loading, manual and inverse optimization for intracavitary brachytherapy on a subset of tandem/ovoid cases.
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Comparison of DVH parameters and loading patterns of standard loading, manual and inverse optimization for intracavitary brachytherapy on a subset of tandem/ovoid cases.

机译：DVH参数和标准加载方式，手动和反向优化的串联模式/卵形子集的腔内近距离治疗的比较。

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PURPOSE: Comparison of inverse planning with the standard clinical plan and with the manually optimized plan based on dose-volume parameters and loading patterns. MATERIALS AND METHODS: Twenty-eight patients who underwent MRI based HDR brachytherapy for cervix cancer were selected for this study. Three plans were calculated for each patient: (1) standard loading, (2) manual optimized, and (3) inverse optimized. Dosimetric outcomes from these plans were compared based on dose-volume parameters. The ratio of Total Reference Air Kerma of ovoid to tandem (TRAK(O/T)) was used to compare the loading patterns. RESULTS: The volume of HR CTV ranged from 9-68 cc with a mean of 41(+/-16.2) cc. Mean V100 for standard, manual optimized and inverse plans was found to be not significant (p=0.35, 0.38, 0.4). Dose to bladder (7.8+/-1.6 Gy) and sigmoid (5.6+/-1.4 Gy) was high for standard plans; Manual optimization reduced the dose to bladder (7.1+/-1.7 Gy p=0.006) and sigmoid (4.5+/-1.0 Gy p=0.005) without compromising the HR CTV coverage. The inverse plan resulted in a significant reduction to bladder dose (6.5+/-1.4 Gy, p=0.002). TRAK was found to be 0.49(+/-0.02), 0.44(+/-0.04) and 0.40(+/-0.04) cGy m(-2) for the standard loading, manual optimized and inverse plans, respectively. It was observed that TRAK(O/T) was 0.82(+/-0.05), 1.7(+/-1.04) and 1.41(+/-0.93) for standard loading, manual optimized and inverse plans, respectively, while this ratio was 1 for the traditional loading pattern. CONCLUSIONS: Inverse planning offers good sparing of critical structures without compromising the target coverage. The average loading pattern of the whole patient cohort deviates from the standard Fletcher loading pattern.
机译：目的：将反向计划与标准临床计划以及基于剂量-体积参数和加载模式的手动优化计划进行比较。材料与方法：本研究选择了28例接受了基于MRI的HDR近距离放射治疗子宫颈癌的患者。为每个患者计算了三个计划：（1）标准负荷，（2）手动优化和（3）逆优化。基于剂量-体积参数比较了这些计划的剂量学结果。卵形与串联的总参考空气比值（TRAK（O / T））的比率用于比较加载方式。结果：HR CTV的体积为9-68 cc，平均为41（+/- 16.2）cc。发现标准，手动优化和反向计划的平均V100不显着（p = 0.35、0.38、0.4）。对于标准计划，膀胱（7.8 +/- 1.6 Gy）和乙状结肠（5.6 +/- 1.4 Gy）的剂量较高;手动优化可减少膀胱（7.1 +/- 1.7 Gy p = 0.006）和乙状结肠（4.5 +/- 1.0 Gy p = 0.005）的剂量，而不会影响HR CTV的覆盖范围。相反的计划导致膀胱剂量显着减少（6.5 +/- 1.4 Gy，p = 0.002）。对于标准装载，手动优化和反向计划，TRAK分别为0.49（+/- 0.02），0.44（+/- 0.04）和0.40（+/- 0.04）cGy m（-2）。观察到标准装载，手动优化和反向计划的TRAK（O / T）分别为0.82（+/- 0.05），1.7（+/- 1.04）和1.41（+/- 0.93），而该比率为1为传统加载模式。结论：逆向计划可以很好地保留关键结构，而不会影响目标覆盖范围。整个患者队列的平均负载模式与标准Fletcher负载模式不同。

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