目的 利用Compass三维验证系统对乳腺癌保乳术后调强放射治疗计划进行剂量验证，研究其影响因素并进行分类分析。方法 选择乳腺癌保乳放射治疗女性患者20例，年龄45～74岁，中位年龄59岁;侧别，左侧10例，右侧10例。用Compass系统进行计划剂量验证，包括独立核算验证和实测重建剂量验证;将Monaco计划系统蒙卡算法计算的剂量(MCD)、Compass卷积/超分割算法独立核算剂量(CCD)和Compass实测重建剂量(CRD)三者之间两两剂量验证结果进行两两比较(CCD-MCD、CRD-CCD、CRD-MCD)，比较参数包括靶区剂量最大限值10％生成区域的γ结果及剂量体积直方图(DVH)结果。结果 CRD-MCD与CRD-CCD的γ通过率和平均γ值差异均有统计学意义[(95。23±2。38)％vs(96。33±2。72)％、(94。78±2。56)％vs(95。97±2。95)％、0。41±0。04 vs 0。37±0。04、0。42±0。04 vs 0。38±0。04。P＜0。05]，CRD-MCD与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(95。23±2。38)％vs(99。29±0。46)％、(94。78±2。56)％vs(99。26±0。46)％、0。41±0。04 vs 0。26±0。03、0。42±0。04 vs 0。27±0。03。P＜0。05]，CRD-CCD 与CCD-MCD的γ通过率和平均γ值差异也均有统计学意义[(96。33±2。72)％vs(99。29±0。46)％、(95。97±2。95)％vs(99。26±0。46)％、0。37±0。04 vs 0。26±0。03、0。38±0。04 vs 0。27±0。03。P＜0。05]。计划肿瘤靶区(PGTV)的D％％和计划靶区(PTV)的Dmean、健侧乳腺的Dmean、V5和患侧肺的V20、V30的剂量体积相对偏差在CRD-MCD与CRD-CCD比较，差异有统计学意义[(2。01±1。27)％vs(2。60±1。05)％、(2。84±0。55)％vs(2。55±0。71)％、(-11。15±7。87)％vs(-18。29±7。91)％、(-1。45±5。45)％vs(-2。76±3。83)％、(-0。85±0。36)％vs(-0。65±0。23)％、(-0。56±0。37)％vs(-0。38±0。27)％。P＜0。05]。PGTV 的 P98％、D2％、Dmean，PTV 的D98％、D2％、Dmean，心脏的Dmean、健侧乳腺的 Dmean、V5，健侧肺的 V5 和患侧肺的v5、V20V30的剂量体积相对偏差在CRD-MCD与CCD-MCD比较，差异均有统计学意义[(2。01±1。27)％vs(-0。51±0。54)％、(2。86±1。22)％vs(-0。002±0。92)％、(2。63±0。75)％vs(-0。19±0。40)％、(2。17±0。82)％vs(0。38±1。01)％、(2。81±0。95)％vs(-0。17±0。70)％、(2。84±0。55)％vs(0。29±0。43)％、(-17。39±7。79)％vs(0。87±3。30)％、(-11。15±7。87)％vs(9。27±4。87)％、(-1。45±5。45)％vs(2。01±1。30)％、(-0。24±0。80)％vs(0。01±0。04)％、(-4。60±0。87)％vs(0。27±0。59)％、(-0。85±0。36)％vs(-0。21±0。21)％、(-0。56±0。37)％vs(-0。22±1。34)％。P＜0。05]。PGTV 的D98％、D2％、Dmean，PTV的D98％、D2％、Dmean，心脏的Dmean、健侧乳腺的 Dmean、V5，健侧肺的V5和患侧肺的v5、V20、V30的剂量体积相对偏差在CRD-CCD与CCD-MCD比较，差异均有统计学意义[(2。60±1。05)％vs(-0。51±0。54)％、(2。88±1。12)％vs(-0。002±0。92)％、(2。83±0。68)％vs(-0。19±0。40)％、(1。81±0。90)％vs(0。38±1。01)％、(2。87±0。82)％vs(-0。17±0。70)％、(2。55±0。71)％vs(0。29±0。43)％、(-18。10±7。40)％vs(0。87±3。30)％、(-18。29±7。91)％vs(9。27±4。81)％、(-2。76±3。83)％vs(2。01±1。30)％、(-0。25±0。81)％vs(0。01±0。04)％、(-4。90±1。03)％vs(0。27±0。59)％、(-0。65±0。23)％vs(-0。21±0。21)％、(0。38±0。27)％vs(-0。22±1。34)％。P＜0。05]。结论 不同算法在高剂量区、低剂量区和肺等组织密度比较大或者含空腔的组织中计算精度偏差更加显著;机器的稳定性状态对剂量差异亦有影响。
Application and analysis of related influencing factors of Compass verification system in breast cancer after breast conserving surgery intensity modulated radiation therapy plan verification
Objective To verify dose of intensity-modulated radiotherapy plan after breast conserving surgery for breast can-cer by using Compass three-dimensional verification system,as well as study and classify the influencing factors.Methods A total of 20 female patients with breast cancer treated with breast conserving radiotherapy were enrolled,which aged 45-74 years old with mean median age of 59 years old.There were 10 cases on the left and 10 cases on the right.The planned dose verification was performed with Compass system,which included independent accounting verification and measured reconstruc-tion dose verification.The dose verification results of Monaco planning system Monte Carlo algorithm calculated dose(MCD),Compass convolution/super segmentation algorithm independent calculation dose(CCD)and Compass measured reconstruction dose(CRD)were compared in pairs(CCD-MCD,CRD-CCD,CRD-MCD),the parameters included γ results and dose volume histogram(DVH)results of the maximum dose limit of 10％target volume.Results There were significant differences in γ-pass rate and mean γ value between CRD-MCD and CRD-CCD[(95.23±2.38)％vs(96.33±2.72)％,(94.78±2.56)％vs(95.97±2.95)％,0.41±0.04 vs 0.37±0.04,0.42±0.04 vs 0.38±0.04.P＜0.05],there were statistically significant differences in γ-pass rate and mean γ value between CRD-MCD and CCD-MCD[(95.23±2.38)％vs(99.29±0.46)％,(94.78±2.56)％vs(99.26±0.46)％,0.41±0.04 vs 0.26±0.03,0.42±0.04 vs 0.27±0.03.P＜0.05],and there were statistically significant differ-ences in γ-pass rate and mean γ value between CRD-CCD and CCD-MCD[(96.33±2.72)％vs(99.29±0.46)％,(95.97±2.95)％vs(99.26±0.46)％,0.37±0.04 vs 0.26±0.03,0.38±0.04 vs 0.27±0.03.P＜0.05].The relative deviation of planning gross target volume(PGTV)D98％and planning target volume(PTV)Dmean,contralateral breast Dmean,V5 and ipsilateral lung V20,V30 were statistically significant differences between CRD-MCD and CRD-CCD[(2.01±1.27)％vs(2.60±1.05)％,(2.84±0.55)％vs(2.55±0.71)％,(-11.15±7.87)％vs(-18.29±7.91)％,(-1.45±5.45)％vs(-2.76±3.83)％,(-0.85±0.36)％vs(-0.65±0.23)％,(-0.56±0.37)％vs(-0.38±0.27)％.P＜0.05].The dose volume relative deviation of PGTV D98％,D2％,Dmean,PTV D98％,D2％,Dmean,heartD,contralateral breast Dmean,V5,contralateral lung V5,and ipsilateral lung V5,V20,V30 were statistically significant differences between CRD-MCD and CCD-MCD[(2.01±1.27)％vs(-0.51±0.54)％,(2.86±1.22)％vs(-0.002±0.92)％,(2.63±0.75)％vs(-0.19±0.40)％,(2.17±0.82)％vs(0.38±1.01)％,(2.81±0.95)％vs(-0.17±0.70)％,(2.84±0.55)％vs(0.29±0.43)％,(-17.39±7.79)％vs(0.87±3.30)％,(-11.15±7.87)％vs(9.27±4.87)％,(-1.45±5.45)％vs(2.01±1.30)％,(-0.24±0.80)％vs(0.01±0.04)％,(-4.60±0.87)％vs(0.27±0.59)％,(-0.85±0.36)％vs(-0.21±0.21)％,(-0.56±0.37)％vs(-0.22±1.34)％.P＜0.05].The dose volume relative deviation of PGTVD98％,D2％,Dmean,PTV D98％,D2％,Dmean,heart Dmean,contralateral breast Dmean,V5,contralateral lung V5,and ipsilateral lung V5,V20,V30 were statistically significant differences between CRD-CCD and CCD-MCD[(2.60±1.05)％vs(-0.51±0.54)％,(2.88±1.12)％vs(-0.002±0.92)％,(2.83±0.68)％vs(-0.19±0.40)％,(1.81±0.90)％vs(0.38±1.01)％,(2.87±0.82)％vs(-0.17±0.70)％,(2.55±0.71)％vs(0.29±0.43)％,(-18.10±7.40)％vs(0.87±3.30)％,(-18.29±7.91)％vs(9.27±4.81)％,(-2.76±3.83)％vs(2.01±1.30)％,(-0.25±0.81)％vs(0.01±0.04)％,(-4.90±1.03)％vs(0.27±0.59)％,(-0.65±0.23)％vs(-0.21±0.21)％,(0.38±0.27)％vs(-0.22±1.34)％.P＜0.05].Conclusion It is demonstrated that the algorithm difference is more significant in high-dose vol-ume,low-dose volume,as well as lung and other tissues with high tissue density or cavities.Meantime,the machine stability state also affects the difference of dose.
Compassbreast conserving radiotherapy for breast cancerthree-dimensional dose verificationMonte Carlo algorithmcollapsed cone convolution algorithm
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