Multicriteria optimization in intensity-modulated radiation therapy treatment planning for locally advanced cancer of the pancreatic head.
Multicriteria optimization in intensity-modulated radiation therapy treatment planning for locally advanced cancer of the pancreatic head.
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DOI：
10.1016/j.ijrobp.2008.07.015
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发表时间：
2008-11-15
影响因子：
7
通讯作者：
Bortfeld, Thomas R.
中科院分区：
文献类型：
--
作者：
Hong, Theodore S.;Craft, David L.;Carlsson, Fredrik;Bortfeld, Thomas R.
调强放射治疗（IMRT）通过创造高度适形的剂量分布，提供了降低放射治疗相关毒性的潜力。然而，逆向规划过程可以创建一个次优计划，尽管满足所有约束。多准则优化（MCO）可以减少制定令人满意的计划所需的耗时迭代循环，同时提供有关不同治疗计划目标之间权衡的信息。在本探索性研究中，我们探讨了MCO在局部晚期胰腺癌（LAPC）患者医生计划选择中的可行性和实用性。对前10例连续接受IMRT治疗的LAPC患者进行评估。建立了满足逆向规划目标的平面数据库（Pareto曲面）。然后，医生从帕累托表面上肾脏剂量最小的点导航到一个“最佳”计划。所有10例患者均采用帕累托面。医生能够在10分钟内从帕累托面为所有病例选择一个方案。与原始（治疗）IMRT计划相比，从帕累托表面选择的计划在10名患者中有9名患者的胃平均剂量较低，尽管通常以高于治疗计划的肾脏剂量为代价。多标准优化在LAPC中是可行的，可以使医生快速选择满意的方案。一般来说，如果有机会，医生会选择胃剂量较低的方案。MCO使医生能够为IMRT计划过程提供更积极的临床投入。
Intensity modulated radiation therapy (IMRT) affords the potential to decrease radiation therapy associated toxicity by creating highly conformal dose distributions. However, the inverse planning process can create a suboptimal plan in spite of meeting all constraints. Multicriteria optimization (MCO) may reduce the time-consuming iteration loop necessary to develop a satisfactory plan while providing information regarding tradeoffs between different treatment planning goals. In this exploratory study, we examine the feasibility and utility of MCO in physician plan selection in patients with locally advanced pancreatic cancer (LAPC). The first 10 consecutive LAPC patients treated with IMRT were evaluated. A database of plans (Pareto surface) was created which met the inverse planning goals. The physician then navigated to an “optimal” plan from the point on the Pareto surface at which kidney dose was minimized. Pareto surfaces were created for all 10 patients. A physician was able to select a plan from the Pareto surface within 10 minutes for all cases. Compared to the original (treated) IMRT plans, the plan selected from the Pareto surface had a lower stomach mean dose in 9 of the 10 patients, though often at the expense of higher kidney dose than the treated plan. Multicriteria optimization is feasible in LAPC and allows the physician to choose a satisfactory plan quickly. Generally, when given the opportunity, the physician will choose a plan with a lower stomach dose. MCO enables a physician to provide greater active clinical input into the IMRT planning process.
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影响因子：
3.5
作者：
Jelen, U;Söhn, M;Alber, M
通讯作者：
Alber, M
影响因子：
3.8
作者：
Spalding, Aaron C.;Jee, Kyung-Wook;Ben-Josef, Edgar
通讯作者：
Ben-Josef, Edgar
DOI：
10.1016/j.ijrobp.2007.08.019
发表时间：
2007-12-01
影响因子：
7
作者：
Craft, David;Halabi, Tarek;Bortfeld, Thomas
通讯作者：
Bortfeld, Thomas
影响因子：
3.8
作者：
AHNESJO, A;SAXNER, M;TREPP, A
通讯作者：
TREPP, A
影响因子：
45.3
作者：
KLAASSEN, DJ;MACINTYRE, JM;MOERTEL, CG
通讯作者：
MOERTEL, CG