本文選題：Rapid + Plan��； 參考：《中國醫(yī)學(xué)物理學(xué)雜志》2016年07期

【摘要】：目的:以統(tǒng)計(jì)圖表和參數(shù)為依據(jù),分析處理瓦里安Rapid Plan模型離群值,并比較處理前后計(jì)劃之間及其與人工優(yōu)化的劑量學(xué)差異。方法:(1)選取80例直腸癌術(shù)前同步推量計(jì)劃建立模型;(2)修正明顯原因所致的離群值;(3)利用擬合曲線、Z值和庫克距離尋找?guī)缀坞x群值,檢查原計(jì)劃并分情況處理;(4)利用殘差分布圖、劑量體積直方圖、學(xué)生化殘差值和庫克距離判斷劑量離群值并酌情處理;(5)利用20例同類計(jì)劃測試驗(yàn)證前后模型的優(yōu)化效果。結(jié)果:統(tǒng)計(jì)學(xué)驗(yàn)證使模型構(gòu)成計(jì)劃中的離群參數(shù)最大值顯著降低(P0.05)。相比原人工優(yōu)化的測試計(jì)劃,Rapid Plan使用任一模型均能顯著改善靶區(qū)均勻性指數(shù)(P0.05,幅度2.7%~19.0%)和膀胱平均劑量(P0.05,降幅12.8%~13.2%)。但利用驗(yàn)證前后模型分別優(yōu)化的計(jì)劃質(zhì)量差異不大:腫瘤計(jì)劃靶區(qū)(PGTV)均勻性指數(shù)相差0.5%,PGTV適形指數(shù)相差0.1%,計(jì)劃靶區(qū)適形指數(shù)相差0.5%,股骨頭和膀胱平均劑量分別相差0.3%和0.4%(P0.05)。結(jié)論:基于知識的Rapid Plan計(jì)劃可以改善靶區(qū)劑量均勻性和保護(hù)危及器官。依據(jù)統(tǒng)計(jì)學(xué)參數(shù)刪改模型構(gòu)成計(jì)劃并不一定能取得更好的劑量學(xué)效果。
[Abstract]:Aim: based on statistical charts and parameters, the outliers of Varian Rapid Plan model were analyzed, and the dosimetric differences between plans and artificial optimization were compared before and after treatment. Methods: (1) 80 cases of rectal cancer were selected to set up a model with synchronous push plan before operation; (2) outliers caused by obvious causes were corrected; (3) geometric outliers were found by using fitting curve Z value and Cook distance, and the original plan was checked and processed by case; (4) residual distribution map was used. Dose volume histogram, student-based residuals and Cook distance were used to judge the dose outliers and to deal with them as appropriate. (5) the optimization effect of the model was verified by 20 similar programs. Results: statistical verification significantly reduced the maximum value of outliers in the model planning (P0.05). Compared with the original artificial test plan, Rapid Plan could significantly improve the target area uniformity index (P0.05, range 2.7U 19.0%) and the average bladder dose (P0.05, decrease 12.8m 13.2%) using any model. The difference of PGTV homogeneity index (PGTV) was 0. 5%, PGTV conformability index was 0. 5% and 0. 5%, and the average dose difference of femoral head and bladder was 0. 3% and 0. 4% respectively (P0.05). Conclusion: Knowledge-based Rapid Plan can improve the dose uniformity of target area and protect endangered organs. The formulation of the model based on statistical parameter deletion does not necessarily achieve better dosimetry results.
【作者單位】： 北京大學(xué)腫瘤醫(yī)院暨北京市腫瘤防治研究所放療科 惡性腫瘤發(fā)病機(jī)制及轉(zhuǎn)化研究教育部重點(diǎn)實(shí)驗(yàn)室;
【基金】：國家自然科學(xué)基金(11505012,81402535) 北京市醫(yī)院管理局“青苗”計(jì)劃專項(xiàng)(QML20151004) 質(zhì)檢公益性行業(yè)科研專項(xiàng)(201510001-02)
【分類號】：R730.55

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