对 VMAT 自动乳腺治疗计划进行剂量学评估:建立机构计划可接受性标准

G. Acquah, F. Hasford, S. Tagoe, Adama Diakite, Victor Adjenou, Ernest Osei
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摘要

摘要 导言:目的:在制定可接受性标准时,评估当前基于设施的治疗计划方案的临床适用性。材料与方法对2021年1月至2023年1月期间完整乳腺癌和胸壁癌患者的自动容积弧治疗(VMAT)治疗计划进行回顾性评估。结果共有 94 名患者使用自动轮廓和 VMAT 计划技术进行了计划和治疗。计划和治疗的完整乳房和胸壁患者人数分别为41人(43.6%)和53人(56.4%)。接受规定剂量 95% 和 105% 的优化治疗 (Brst_opt) 的平均完整乳房体积分别为 92.80% ± 1.11 和 1.54% ± 1.02。相应的优化胸壁平均体积(Chst_opt)分别为 90.65% ± 3.19 和 2.28% ± 2.99。对于左侧病例,完整乳房计划和胸壁计划的平均心脏剂量分别为 4.61 Gy ± 1.76 和 5.18 Gy ± 1.55。在完整乳房计划和胸壁计划中,接受规定剂量 20 Gy 的同侧肺平均体积分别为 12.22% ± 3.86 和 13.19% ± 3.74。计算出的Brst_opt和Chst_opt剂量指标的平均均匀性指数(HI)分别为0.14±0.03和0.15±0.04,平均均匀性指数(UI)分别为1.09±0.03和1.11±0.03,平均符合性指数(CI)分别为0.92±0.04和0.91±0.04。结论剂量学评估显示,靶体积的剂量分布良好,危险器官(OAR)的剂量最小。对当前数据的评估肯定了该机构采用的方案在实现完整乳房和胸壁照射的高质量治疗计划方面的临床实用性。制定计划可接受性标准将有助于改善整体治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dosimetric evaluation of VMAT automated breast treatment plans: Towards the establishment of an institutional plan acceptability criteria
Abstract Introduction: To evaluate the clinical suitability of the current facility-based treatment plan protocol in establishing acceptability criteria. Material and methods: Automated Volumetric Arc Therapy (VMAT) treatment plans were retrospectively evaluated for intact breast and chest-wall cancer patients from January 2021 to January 2023. Results: A total of 94 patients were planned and treated using automated contouring and VMAT planning technique. The number of patients planned and treated for intact breast and chest-wall were 41 (43.6%) and 53 (56.4%), respectively. The mean intact breast volumes for optimization (Brst_opt) receiving 95% and 105% of the prescribed doses were 92.80% ± 1.11 and 1.54% ± 1.02, respectively. Their corresponding mean chest-wall volumes for optimization (Chst_opt) were 90.65% ± 3.19 and 2.28% ± 2.99, respectively. For left-sided cases, the mean heart dose received was 4.61 Gy ± 1.76 and 5.18 Gy ± 1.55 for intact breast plans and that for chest-wall plans, respectively. The mean ipsilateral lung volume receiving 20 Gy of the prescribed dose was 12.22% ± 3.86 and 13.19% ± 3.74 for intact breast plans and chest-wall plans, respectively. For the Brst_opt and Chst_opt dose metrics were calculated; the mean homogeneity index (HI) was 0.14 ± 0.03 and 0.15 ± 0.04, mean uniformity index (UI) was 1.09 ± 0.03 and 1.11 ± 0.03, and mean conformity index (CI) were 0.92 ± 0.04 and 0.91 ± 0.04, respectively. Conclusions: The dosimetric evaluation shows a good dose distribution in the target volumes with minimal doses to the organs at risk (OAR). Assessment of the current data affirms the clinical usefulness of the facility-adopted protocol in achieving quality treatment plans for intact breast and chest-wall irradiations. The establishment of plan acceptability criteria will help achieve improved overall treatment outcomes.
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