ABSTRACT
Objective The aim of this study was to evaluate the role of multicriteria optimization (MCO) in planning of intensity-modulated radiotherapy (IMRT).Methods Twenty IMRT patients (ten with prostate and ten with lung cancers) were randomly selected.For these patients,the treatment plans were designed with direct machine parameter optimization (DMPO).Based on these plans,new plans were designed with MCO,while keeping the setting conditions unchanged.Comparison was made between the two plans including the dose distribution,the dose volume histogram,the time of optimization and number of monitor unit (MU),but were play by pairing-t test.Results The plan designed in both optimizations satisfied all clinical requirements.For the same or better target coverage,rectum,bladder and small bowel were better with MCO compared with DMPO,MCO reduced 58％ of the time for optimization by average while MU increased 32％ by average for prostate cancer.For lung cancer,the whole lung,heart and spinal cord were better with MCO compared with DMPO,MCO reduced 59％ of the time for optimization by average while MU increased 11％ by average.Conclusions In comparison with DMPO,MCO reduces the dose of organs at risk,shorten the time of optimization.
ABSTRACT
Objective To evaluate the role of equivalent uniform dose (EUD) in planning optimization of intensity-modulated radiotherapy (IMRT) for prostate cancer.Methods Ten patients with prostate cancer were randomly selected who treated with IMRT.For these patients,the treatment plans were designed with dose-volume objectives.Based on these plans,new plans were designed through replacing the dose-volume objectives with maximum EUD for rectum,bladder and small bowel,while keeping the dosevolume objectives unchanged.Comparison was made between the new plans and the former cones by paired t-test.Results The conformity index of planning target volume was better with EUD optimization compared to dose-volume (1.00 ± 0.04 ∶ 0.94 ± 0.04,t =3.80,P =0.04).The D53,D30 and Dicm3 for rectum was better with EUD optimization compared to dose-volume (24.4 ± 2.7 ∶ 25.5 ± 2.6,t =-3.82,P =0.004,34.1 ±4.3∶39.1±2.1,t=-3.80,P=0.004 and51.4±1.0∶51.8±0.9,t=-2.42,P=0.039),with V10,V20 for bladder and V10,V20,V30,V40 for small bowel also better with EUD optimization (92.2 ±6.2∶99.4±1.1,t=-4.28,P=0.002;70.7±5.7∶78.7±6.3,t=-3.10,P=0.013 and 62.2±30.2∶74.7 ±30.0,t =-4.18,P =0.002;34.3 ±26.3∶46.5 ±30.9,t =-5.46,P =0.000;17.1 ±17.0∶25.1 ±22.6,t=-3.52,P=0.007;10.6± 11.5∶ 15.6± 16.1,t=-2.64,P=0.030).Conclusions The conformity index of planning target volume is better with EUD optimization compared to dose-volume.And the dose to rectum,bladder and small bowel can be reduced through optimization with EUD optimization compared to dose-volume.