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Objective:To realize the automatic evaluation of the target conformity, dose overflow, dose drop and other indicators in stereotactic body radiation therapy (SBRT) plan for the early non-small cell lung cancer (NSCLC) in the Eclipse planning system.Methods:Eclipse Scripting API application development interface and C# programming language were used to develop it with script plug-ins combined with independent programs. According to the requirements of the NSCLC SBRT plan in Radiation Therapy Oncology Group (RTOG) 0915 report, the automatic evaluation of related indicators was realized. A rule of equal interval sampling and double thresholds was designed during the period, which could more accurately and conveniently evaluate the dose drop outside the target area.Results:13 clinical cases of NSCLC SBRT plans were randomly selected, the method in this study and the module equipped with the Eclipse system to were utilized to evaluate and compare the results. It was concluded that the results of the two methods were in line with the clinical requirements, and the former was more efficient ( P<0.05). Conclusions:The NSCLC SBRT plan evaluation software in this article has a friendly interface. It can not only realize the automatic evaluation of target conformity, dose overflow and dose drop, but also effectively improve work efficiency and better serve the clinical and scientific research work of radiotherapy.
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Objective:To propose an automatic planning approach for Eclipse15.6 planning system based on Eclipse scripting application programming interface (ESAPI) and evaluate its clinical application.Methods:20 patients with nasopharyngeal carcinoma and 20 cases of rectal cancer were selected in the clinical planning. The developed automatic planning script SmartPlan and RapidPlan were used for automatic planning and dosimetric parameters were compared with manual planning. The differences were compared between two groups by using Wilcoxon signed rank test. Results:The dosimetric results of automatic and manual plans could meet clinical requirements. There was no significant difference in target coverage in nasopharyngeal carcinoma planning between two groups ( P>0.05), and automatic plans were superior to manual plans in organs at risk sparing ( P<0.05). Except for the homogeneity index of PTV and the maximum dose of bowel in rectal cancer plans, the other dosimetric parameters of the automatic plans were better than those of the manual plans (all P<0.05). Conclusions:Compared with the manual plans, the automatic plans have the same or similar target coverage, similar or better protection of organs at risk, and more convenient implementation. The developed SmartPlan based on ESAPI has clinical feasibility and effectiveness.
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Objective:To realize the interactive form evaluation of radiotherapy dose and the automatic calculation of conformity index (CI) and heterogeneity index (HI) in the Eclipse planning system.Methods:The Eclipse Scripting API application development interface and C# programming language were employed to develop it with script plug-ins combined with independent programs. The visual interface programming and call the relevant dose query function in the API were utilized to realize the interactive table dose evaluation and the automatic calculation of HI. The functions of calling dosage structure creation and structure Boolean operation in the API were adopted to realize the automatic calculation of CI.Results:15 clinical radiotherapy cases of nasopharyngeal carcinoma were selected. The dose evaluation results were statistically compared between this method and the module equipped in the Eclipse system. The results showed that the accuracy was consistent between these two methods ( P>0.05), whereas the evaluation efficiency of this method was significantly higher compared with that of the Eclipse system module ( P<0.05). Conclusions:The interactive evaluation form in this article has a friendly interface, which allows users to more conveniently perform dose assessment, multi-plan comparison, and calculation of CI and HI, which effectively improves work efficiency and can better serve the clinical and scientific research work of radiotherapy.
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No século XXI, o problema da psicanálise é a extensão do nível de competência clínica da escuta psicanalítica e suas implicações na complexidade de nossos modelos. Para avançar nessa questão, apoiar-me-ei na análise de um paciente que já passara por muitas análises. Embora a psicanálise tenha sempre os mesmos fundamentos, baseados na transferência e na escuta das associações, os modelos desses processos têm de se tornar mais complexos e extensos. A ampliação da competência da escuta psicanalítica para os sofrimentos narcísicos, que têm um forte impacto sobre a identidade, exige o refinamento de novas ferramentas, que passam por uma compreensão mais profunda da primeiríssima infância, em particular das formas primárias de simbolização, e pela dilatação do contexto de referência da escuta, baseado não só na vida pulsional, mas também nas respostas de objetos significativos a movimentos pulsionais. Por fim, essas questões conduzem a uma possível ampliação do enquadre analítico vinculada ao tipo específico de associatividade dos analisandos.
The problem of psychoanalysis in the twentyfirst century lies in its level of clinical skills in psychoanalytic listening, and how this affects the complexity of our models. In order to move forward with this issue, my ideas will be supported by the analysis of a patient who has already been analyzed several times. Although psychoanalysis fundamentals are always the same (based on transference and listening of associations), the models of these processes must become more complex and extensive. Extending psychoanalytic listening skills for narcissistic suffering, which severely affects identity, requires the refinement of new tools that provide a deeper understanding of the very first childhood, particularly of the primary forms of symbolization, and an expanded context of listening reference that is based not only in pulsional life, but also in the significant objects' response to pulsional movements. Lastly, these issues lead to a possible analytic frame expansion which is bound to a specific form of analysands' associative process.
En el siglo 21, el problema del psicoanálisis es la extensión del nivel de competencia clínica de la escucha psicoanalítica y sus implicaciones en la complejidad de nuestros modelos. Para avanzar en este punto, me apoyaré en el análisis de un paciente que ya pasó por muchos análisis. Aunque el psicoanálisis tenga siempre los mismos fundamentos, basados en la transferencia y en la escucha de las asociaciones, los modelos de esos procesos tienen que tornarse más complejos y extensos. La ampliación de la competencia de la escucha psicoanalítica para los sufrimientos narcisísticos, que tienen un fuerte impacto sobre la identidad, exige refinar nuevas herramientas, que pasan por una comprensión más profunda de la primerísima infancia, en particular de las formas primarias de simbolización, y por la dilatación del contexto de referencia de la escucha, basado no solo en la vida pulsional, sino también en las respuestas de objetos significativos para movimientos pulsionales. Finalmente, esos temas conducen a una posible ampliación del encuadre analítico vinculado al tipo específico de asociación de los analizados.