RESUMO
Objective:To study the clinical feasibility and advantages of the RapidPlan module based on Halcyon 2.0 ring medical linear accelerator in the design of volumetric modulated arc therapy (VMAT) plans after cervical cancer surgery.Methods:The data of 98 clinical cervical cancer cases were selected from the database, and VMAT artificial radiotherapy plans were designed based on Halcyon 2.0. Then, the designed plans were imported into the RapidPlan module to train the module for a prediction model with high goodness of fit. Another 20 patients after cervical cancer surgery were selected as the validation set to compare the differences in dosimetry, plan consistency, and plan execution efficiency between the manual plans and RapidPlan automatic plans.Results:The RapidPlan automatic plans could obtain dose distribution of target volume and organs at risk with the same quality as the manual plans. The RapidPlan automatic plans provided slightly inferior protection of the femoral head but superior protection of the spinal cord compared to the manual plans, and the difference was statistically significant ( t = 4.71, P<0.001). The average MU of the RapidPlan automatic plans was 687.46, which was lower than that of the manual plan (815.34), and the difference was statistically significant ( t = 6.09, P < 0.05). The portal dosimetry (PD) verification revealed that the average γ passing rate (1 mm/1%) of the RapidPlan automatic plans was 89.48%and that of the manual plans was 88.22%, and the difference was statistically significant ( t = 3.35, P < 0.05). Conclusion:RapidPlan automatic plans based on the Halcyon 2.0 platform can meet the clinical needs of the VMAT program for cervical cancer and has certain advantages.
RESUMO
Objective:To compare three fixed-field intensity-modulated radiotherapy (IMRT) plans for nasal cavity and paranasal sinus tumors, including the coplanar IMRT (C-IMRT) plan and the non-coplanar IMRT(NC-IMRT) plan which were based on a conventional C-arm LINAC (Trilogy), and the coplanar IMRT (H-IMRT) plan based on an O-ring LINAC (Halcyon).Methods:Based on the data of 10 patients in the Ningbo First Hospital from December 2018 to December 2021 with nasal cavity and paranasal sinus tumors who underwent postoperative radiotherapy, this study redesigned three IMRT plans with the same prescribed doses and optimization objectives. Then, this study compared the doses of target volumes and organ at risks(OARs), the validation pass rates, and the execution time of these plans. Friedman test was employed in this study, and multiple comparisons were further made in cases of different results.Results:The differences in the conformal index (CI) of PTV and PTV boost of the three plans were statistically significant ( χ2 = 7.51, 9.69, P < 0.05). The multiple comparisons showed that the median CI of the H-IMRT plan was higher than that of the NC-IMRT plan ( Z = 2.53, 2.68, P < 0.05). The differences in other parameters of target volumes were not statistically significant. Compared with the C-IMRT plan, the H-IMRT plan reduced the Dmax of bilateral lenses, bilateral corneas, ipsilateral optic nerve, and ipsilateral eyeball ( Z = 2.80, 2.80, 2.80, 2.80, 2.81, 2.09, P < 0.05). Compared with the C-IMRT plan, the NC-IMRT reduced the Dmax of bilateral lenses, corneas, and eyeballs and contralateral optic nerve ( Z = 2.80, 2.66, 2.80, 2.70, 2.29, 2.29, 2.65, P < 0.05) and reduced the Dmean of bilateral eyeballs ( Z = 2.80, 2.80, P < 0.05). Compared with the NC-IMRT plan, the H-IMRT plan reduced the Dmax of the ipsilateral lens and cornea ( Z = 2.50, 2.08, P < 0.05), but increased the Dmax of the contralateral optic nerve and the Dmean of bilateral eyeballs ( Z = 2.80, 2.80, 2.80, P < 0.05). The validation pass rate of the three plans met the institutional standards, and the differences were not statistically significant. Moreover, the H-IMRT plan had the shortest median execution time (172.00 s), followed by the C-IMRT plan (337.50 s), and the NC-IMRT plan (388.00 s). Conclusions:The verification pass rate of the three plans can achieve the requirements of treatment implementation. The three plans had similar dosimetric differences in target volumes. However, the H-IMRT and NC-IMRT plans can protect the normal tissues (especially optical organs) more effectively than the C-IMRT plan, which is conducive to reducing the toxicity after radiotherapy and provides space for local dose increase or the radiotherapy for the treatment of tumor recurrence. The execution efficiency of the three plans is in the order of H-IMRT > C-IMRT > NC-IMRT. It is necessary to select appropriate radiotherapy equipment and technology according to actual situations.