微创医学

目的通过对比宫颈癌调强中自动计划（AP）方式与手工计划（MP）在计划靶区（PTV）和危及器官（OAR）的剂量学差异，探讨宫颈癌自动计划方式的可行性。方法选取接受术前调强放射治疗的10例宫颈癌患者，进行CT模拟定位、靶区和危及器官勾画，用Pinnacle3 9.10治疗计划系统（TPS）对每一组CT图像同时设计AP与MP。在PTV的95%体积达到处方剂量的前提下，比较两种调强计划的剂量体积直方图（DVH），分析靶区均匀性指数（HI）、适形度指数（CI）、OAR受照剂量以及计划时间。结果AP与MP计划相比，在肿瘤区计划靶区（PGTV）的平均剂量Dmean稍有优势、在临床计划靶区（PCTV）的适形度上稍差，差异有统计学意义（P＜0.05）。两种计划所有OAR的剂量学参数比较，差异无统计学意义（P＞0.05）。在优化时间上AP明显优于MP，差异有统计学意义（P＜0.05）。结论AP在保证了计划一致性的同时节省了优化时间，能够提高计划效率。

【Abstract】 ObjectiveTo compare the dosiology of planning target volume（PTV）and organ at risk (OAK) between automatic planning（AP） and manual planning（MP）of intensitymodulated radiotherapy (IMRT), thus to explore the feasibility of AP for cervical cancer.MethodsTen patients with cervical cancer who received preoperative IMRT were enrolled. CT simulation, target and OAR delineation were conducted. AP and MP were designed at the same time in each set of CT images using Pinnacle3 9.10 therapy planning system. On the basis of 95% PTV receiving prescription dose, the dose volume histogram was compared between the two intensitymodulated plans. Homogeneity index(HI), conformity index(CI), radiation dose of OAR and planning time were analyzed. ResultsThe mean dose of the planning gross target volume was slightly superior but the conformity of planning clinical target volume was worse in AP compared to MP（P＜0.05）. There were no significant differences in the dosiology parameters of all OARs between the two plans（P＞0.05）. The optimization time of AP was significantly superior to that of MP（P＜0.05）. ConclusionAP not only maintains the conformity of planning but also can shorten the optimization time and improve the planning effectiveness