|
|
|
| Impact of Fluence Smoothing Setting in Monaco Treatment Planning System on IMRT Plans for Cervical Cancer |
| CAO Mingpeng, LUO Weiming, LYU Changjin, et al |
| Department of Radiotherapy,Minhang Branch,the Cancer Hospital Affiliated to Fudan University,Shanghai 200240 |
|
|
|
|
Abstract 【Objective】To compare the dosimetric differences in inverse intensity-modulated radiation therapy (IMRT) plans for postoperative concurrent dose escalation in cervical cancer using four different fluence smoothing parameters in the Monaco treatment planning system.【Methods】Forty cervical cancer patients were enrolled in the study. Treatment plans were designed and evaluated under the same optimization conditions using high (High), medium (Medium), low (Low), and no (Off) fluence smoothing parameters. The average dose (Dmean), minimum dose (Dmin), conformity index (CI), homogeneity index (HI), organ at risk (OAR) doses, as well as mechanical parameters such as the number of segments, monitor units (MU), and modulation degree (MD) were compared among the four groups.【Results】No statistically significant differences were observed among the four groups regarding Dmin, Dmean, CI, and HI for the target area (P>0.05).There were not any significant differences in OAR dosimetric parameters in the four groups (P>0.05). However, the High group showed significantly better MU and MD values compared to the other three groups (P<0.05). The estimated plan time showed no significant difference among the groups (P>0.05).【Conclusion】All plans designed with the four different fluence smoothing parameters meet the clinical requirements. The use of the High fluence smoothing parameter with a maximum of 30 control points per field in the design of IMRT plans for postoperative concurrent dose escalation in cervical cancer improves plan efficiency.
|
|
Received: 28 June 2024
|
|
|
|
|
|
[1] 葛双, 王寻, 郝会珍, 等. Monaco计划系统不同通量平滑方式对直肠癌术后容积旋转调强放射治疗计划影响的分析[J].河北医学,2021,27(11):1888-1894.
[2] 邱刚, 房保栓, 魏强, 等. 通量平滑度对宫颈癌放射治疗的剂量学影响[J].中国辐射卫生, 2021, 30(3): 288-294.
[3] LIM K, JR W S, PORTELANCE L,et al.Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer[J].Int J Radiat Oncol Biol Phys,2011, 79(2): 348-355.
[4] ANON. Prescribing, Recording, and Reporting Photon-Beam Intensity-Modulated Radiation Therapy (IMRT) Contents[J].J ICRU,2010, 10(1): 1-3.
[5] BALTAS D, KOLOTAS C, GERAMANI K, et al. A conformal index (COIN) to evaluate implant quality and dose specification in brachytherapy [J].Int J Radiat Oncol Biol Phys,1998, 40(2): 515-524.
[6] CAO W F, ZHUANG Y D, CHEN L X, et al. Application of dose-volume histogram prediction in biologically related models for nasopharyngeal carcinomas treatment planning[J].Radiat Oncol,2020,15(1):216.
[7] 国家癌症中心/国家肿瘤质控中心. 调强放疗剂量验证实践指南[J].中华放射肿瘤学杂志, 2020, 29(12): 1021-1024.
[8] 褚薛刚, 邢晓汾, 崔桐, 等. CompassR在宫颈癌调强放疗三维剂量验证中的应用研究[J].中华放射医学与防护杂志, 2015, 35(7): 548-549.
[9] 鲁黎明, 刘攀, 杜锋磊. 通量平滑度对直肠癌术后调强计划的剂量影响[J].中国辐射卫生, 2022, 31(4):464-470.
[10] 潘香, 侯宇, 杨毅, 等. 通量平滑度对左乳癌保乳术后容积旋转调强放疗剂量学的影响[J].现代肿瘤医学, 2021, 29(15): 2691-2695.
[11] ZHAI D Y, YIN Y, GONG G Z, et al. RapidArc radiotherapy for whole pelvic lymph node in cervical cancer with 6 and 15 MV: A treatment planning comparison with fixed field IMRT [J].J Radiat Res,2013, 54(1): 166-173.
[12] 李巧艺, 白龙, 徐庆丰, 等. 放射治疗中小野剂量学的研究进展[J].中国医学物理学杂志, 2020, 37(12): 1477-1481.
[13] MITTAUER K, LU B, YAN G H, et al. A study of IMRT planning parameters on planning efficiency, delivery efficiency, and plan quality [J].Med Phys,2013, 40(6): 061704.
[14] GIORGIA N, ANTONELLA F, EUGENIO V, et al. What is an acceptably smoothed fluence? Dosimetric and delivery considerations for dynamic sliding window IMRT.[J].Rad Oncol,2007, 2(1): 42-54. |
|
|
|
2024, Vol. 41 
