Lokalize prostat kanserli hastalarda yoğunluk ayarlı radyoterapi (IMRT) tekniği kullanılarak standart optimizasyon yöntemi ile çok kriterli optimizasyon (MCO) yönteminin karşılaştırılması

Year 2022, Issue: 38, 16 - 23, 31.08.2022

Ayşe Gülbin Kavak Hatice Coşkun Abdullah Tuncay Demiryürek

https://doi.org/10.31590/ejosat.1078027

Abstract

Bu çalışmada, prostat kanserli hastalar için RayStation tedavi planlama sisteminde çok kriterli optimizasyon (MCO) yöntemi kullanılarak yoğunluk ayarlı radyasyon tedavisi (IMRT) uygulamasını değerlendirmek amaçlandı. Çalışmaya daha önce IMRT ile tedavi edilen toplam 10 ardışık prostat kanseri hastası dahil edildi ve MCO modalitesi kullanılarak yeniden planlandı. Plan kalitesi, risk altındaki organlar (OAR) ve planlama hedef hacminin (PTV) uygunluk indeksi (CI) ve homojenlik indeksi (HI) kullanılarak analiz edildi ve karşılaştırıldı. PTV tabanlı IMRT planlaması ile doz yükseltme, özellikle yüksek doz alanlarında, yüksek OAR dozları ile yakından bağlantılıydı. HI ve CI her iki modalite için benzer olmasına rağmen, IMRT ile karşılaştırıldığında MCO için ortalama monitör birimlerinde belirgin bir düşüş saptandı (P < 0.05). MCO planı, belirgin şekilde mesane ve femur başı için daha iyi koruyucu etkiler gösterdi (P < 0.05). MCO yönteminin IMRT yöntemine göre toplam planlama süresini kısalttığı görülmüştür (P < 0.01). Bulgularımız, MCO'nun plan kalitesini iyileştirdiğini ve PTV kapsamı ve OAR koruması açısından prostat kanseri için üstün bir modalite olduğunu göstermiştir.

Keywords

Yoğunluk ayarlı radyasyon tedavisi, Çok kriterli optimizasyon, Plan kalitesi, Prostat kanseri.

Comparison of standard optimization method and multicriteria optimization (MCO) method using intensity-modulated radiotherapy (IMRT) technique for patients with localized prostate cancer

Abstract

This study aimed to evaluate the implementation of intensity-modulated radiation therapy (IMRT) using multicriteria optimization (MCO) in the RayStation treatment planning system for patients with prostate cancer. A total of 10 consecutive prostate cancer patients previously treated by IMRT were included in this study and re-planned using the MCO modality. The plan quality was analyzed and compared using the conformity index (CI) and homogeneity index (HI) of the dose sparing of organs at risk (OAR) and planning target volume (PTV). Dose–escalation with PTV-based IMRT planning was closely connected with elevated OAR doses, particularly in high-dose areas. Although HI and CI were similar for both modalities, we detected a marked decrease in mean monitor units for MCO when compared to IMRT (P < 0.05). The MCO-plan showed markedly better bladder and femoral heads sparing effects (P<0.05). It has been found that the MCO method shortens the total planning time compared to the IMRT method (P < 0.01). Our findings showed that MCO improved plan quality and was the superior modality for prostate cancer in terms of PTV coverage and OAR sparing.

Keywords

Intensity-modulated radiation therapy, Multicriteria optimization, Plan quality, Prostate cancer.

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