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    背景剂量优化法在前列腺癌序贯放疗中的可行性研究

    Study on the feasibility of background dose optimization method in sequential radiotherapy for prostate cancer

      摘要
    • 摘要:
      目的 分析基于背景剂量优化法在前列腺癌序贯放疗计划设计中的可行性及优缺点。
      方法 选取前列腺癌病人10例, 在Monaco计划系统上设计首程计划(靶区, PTV 50.4 Gy，28次), 然后分别按照常规方法(Normal组)和基于背景剂量优化法(Bias Dose)(Bias组)设计再程计划(肿瘤区, GTV 16 Gy，8次), 比较分析靶区和危及器官的剂量以及机器跳数和执行时间。
      结果 2种计划设计方法靶区剂量均可满足临床要求。在GTV、PTV中, Bias组的D98、Dmean、D2剂量均低于Normal组(P < 0.01), 在PTV的TC剂量差异有统计学意义(P < 0.01)；在HI方面, 对于GTV靶区Bias组呈劣势, 对于PTV靶区Bias组均匀性优于Normal组(P < 0.05和P < 0.01)；Bias组在所有靶区上的CI均高于Normal组(P < 0.01)。Bias组与Normal组机器跳数和执行时间差异均无统计学意义(P>0.05)。在小肠Dmean、左右股骨Dmean、直肠V50剂量指标方面, Bias组明显低于Normal组(P < 0.05~P < 0.01)。
      结论 Bias Dose方法在前列腺癌序贯放疗中可行, 在临床应用中应采用Bias Dose计划以取得更优的临床计划。

       

      Abstract:
      Objective To analyze the feasibility, advantages, and disadvantages of background dose optimization method in sequential radiotherapy planning for prostate cancer.
      Methods Ten patients with prostate cancer treated were selected, and the first course plan (PTV 50.4 Gy/28 fractions) was designed on the Monaco planning system.Then, the second course plan (GTV 16 Gy/8 fractions) was designed according to the conventional method and the background dose optimization method (Bias Dose), respectively.The doses of target and organs at risk, monitor unit and deliver time were compared and analyzed.
      Results The target dose of two plan design methods met clinical requirements.In GTV and PTV, the D98, Dmean, and D2 doses in the Bias group were lower than those in the Normal group (P < 0.01), and there was a statistically significant difference in TC dose of PTV (P < 0.01).In terms of HI, the Bias group in the GTV target area showed a disadvantage, while the Bias group in the PTV target area showed better uniformity than the Normal group (P < 0.05 and P < 0.01).The CI of the Bias group was higher than that of the Normal group in all target areas (P < 0.01).There was no statistically significant difference in machine hop count and execution time between the Bias group and the Normal group (P>0.05).Regarding small intestine Dmean, left and right femur Dmean, and rectal V50 dose indicators, the Bias group was significantly lower than the Normal group (P < 0.05 to P < 0.01).
      Conclusions Bias Dose method is feasible in sequential radiotherapy of prostate cancer.Bias dose plan should be used in clinical application to obtain better clinical plan.

       

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