Analysis on Effect of Different Flux Smoothing Methods of Monaco Planning System on Postoperative Volume Rotary Intensity Modulated Radiotherapy for Rectal Cancer
GE Shuang, WANG Xun, CHI Huizhen, et al
Affiliated Hospital of Jining Medical University, Shandong Jining 272001, China
Abstract：Objective: To investigate the dosimetric differences of volume rotary intensity modulated radiotherapy (VMAT) plan designed by three different flux smoothing methods in Monaco plan system. Methods: 16 patients with rectal cancer were randomly selected to design VMAT plans (FSH, FSM, FSL) by three different fluence smoothing modes under the same optimized conditions and used the Monaco 5.11 TPS and the VersaHD accelerator model. The dose verification was measured by matrixx detector. The parameters mainly included the target volume and OAR dose-volume histogram, as well as conformity index (CI), homogeneity index (HI), dose gradient index (GI), monitor unit (MU), control point (CP), beam time (T) and gamma pass rate (GRP) were considered. Results: Ci of FSL was significantly better than that of FSM and FSH, hi was slightly better than that of FSM and FSH, GI was similar to that of FSM, and both were better than that of FSH group. Both FSL and FSM had obvious advantages in increasing Dmin and D98% of PTV. Compared with FSH, FSL and FSM could increase by 2.84% (P<0.05). In oar, Dmean, V30, V40 and FSL of bladder were lower than those of FSM and FSH, with the maximum of 3.76% and 7.01% (P<0.05); Dmean, V20 and FSL of the right femoral head decreased by 9.10% compared with FSM and FSH (P<0.05); FSL and FSM were slightly better than FSH in the protection of left femoral head; In terms of intestinal protection, the results of the three were similar. The average values of FSH and FSM were 15.93% and 8.68% lower than that of FSL for CP, were decreased by 14.30% and 8.33% for mu, 13.39% and 6.91% for t (P<0.05). The difference was statistically significant (P<0.05). The planned GRP of the three groups was greater than 99% under the standard of 3% / 3mm, which met the clinical requirements. However, under the higher standard of 1% / 1mm and 2% / 2mm, the GRP of FSH and FSM was similar, which was significantly higher than that of FSL (P<0.05). Conclusion: In the postoperative VMAT plan for rectal cancer, the dosimetric parameters and GRP of FSH, FSM and FSL can meet the clinical requirements. FSL is superior to FSM and FSH in improving the quality of the plan, reducing the radiation dose and toxic and side effects of bladder and femoral head; FSH and FSM are better than FSL in improving the efficiency of plan implementation. Therefore, when designing the plan, we should comprehensively consider the clinical requirements and individual differences of patients, and give priority to FSM, which can not only meet the better plan quality, but also improve the plan implementation efficiency.
葛双, 王寻, 郗会珍, 马俊, 叶书成, 陈长建, 陈其超, 马守印, 徐宁. 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.
GE Shuang, WANG Xun, CHI Huizhen, et al. Analysis on Effect of Different Flux Smoothing Methods of Monaco Planning System on Postoperative Volume Rotary Intensity Modulated Radiotherapy for Rectal Cancer. HeBei Med, 2021, 27(11): 1888-1894.
[1] 刘璐,冯林春,刘其腾,等.局部进展期低位直肠癌新辅助放化疗初步临床观察[J],中华放射肿瘤学杂志,2020,29(11):954~958. [2] 孙文洁,章真.直肠癌放射治疗的现状与研究热点[J].中国癌症杂志,2013,23(26):476~480. [3] Kathirvel M,Subramani V,Subramanian VS,et al.Dosimetric comparison of head and neck cancer patients planned with multivendor volumetric modulated arc therapy technology[J].Cancer Res Ther,2017,13(1):122~130. [4] Nguyen TTT,Arimura H,Asamura R,et al.Comparison of volumetric-modulated arc therapy and intensity-modulated radiation therapy prostate cancer plans accounting for cold spots[J].Radiological physics and technology,2019,12(2):137~148. [5] Elcim Y,Dirican B,Yavas O.Dosimetric comparison of pencil beam and Monte Carlo algorithms in conformal lung radiotherapy[J].Appl Clin Med Phys,2018,19(5):616~624. [6] Clements M,Schupp N,Tattersall M,et a.Monaco treatment planning system tools and optimization processes[J].Med Dosim,2018,43(2):106~117. [7] Wang Y,Chen L,Zhu F,et al.A study of minimum segment width parameter on VMAT plan quality,delivery accuracy,and efficiency for cervical cancer using Monaco TPS[J].Appl Clin Med Phys,2018,19(5):609~615. [8] Palanisamy M,David K,Durai M,et al.Dosimetric impact of statistical uncertainty on Monte Carlo dose calculation algorithm in volumetric modulated arc therapy using Monaco TPS for three different clinical cases[J].Rep Pract Oncol Radiother,2019,24(2):188~199. [9] Kalet AM,Richardson HL,Nikolaisen DA,et al.Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system[J].Med Dosim,2017,42(2):122~125. [10] Snyder JE,Hyer DE,Flynn RT,et al.The commissioning and validation of Monaco treatment planning system on an Elekta VersaHD linear accelerator[J].Appl Clin Med Phys,2019,20(1):184~193. [11] Viswanathan AN,Yorke ED,Marks LB,et al.Radiation dose-volume effects of the urinary bladder[J].Int Radiat Oncol Biol Phys,2010,76(3):116~122. [12] Romano KD,Pugh KJ,Trifiletti DM,et al.Transition from LDR to HDR brachytherapy for cervical cancer:Evaluation of tumor control,survival,andtoxicity[J].Brachytherapy,2017,16(2):378~386. [13] 吴凡,刘敏,康盛伟,等.通量平滑度在胸中上段食管癌容积弧形调强中的剂量学比较[J].中华放射医学与防护杂志,2020,40(1):32~35.
2021, Vol. 27 
冀公网安备13080202000677号