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进化智能三目标治疗计划对子宫癌治疗的多功能性基疗法

Leah R M Dickhoff¹, Ellen M Kerkhof¹, Heloisa H Deuzeman¹

¹Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.

Medical physics

|August 12, 2025

概括

三目标的BRIGHT方法快速生成临床上可接受的宫癌支臂疗法计划,允许根据个体患者的需求和偏好进行定制. 这种自动化系统优化剂量分配,以改善治疗结果.

科学领域:

医学物理医学物理
辐射瘤学辐射瘤学
计算生物学计算生物学

背景情况:

BRIGHT (基于目标的整合启发和优化) 系统成功地自动化了前列腺癌支臂疗法 (BT) 计划.
布赖特直接优化剂量-体积指标,与临床目标保持一致,并提供多种治疗计划.
现有的自动化方法缺乏直接的剂量-体积优化,或者产生单一的,潜在的低于最佳的计划.

研究的目的:

通过将第三个目标纳入现有的双目标优化框架,扩大对宫癌支臂治疗的BRIGHT方法.
提出算法适应,展示扩展的Bright系统的灵活性和可定制性.
通过调整的BRIGHT方法生成的治疗计划的临床可接受性进行验证.

主要方法:

扩展的BRIGHT方法包括瘤覆盖,健康器官节省 (EMBRACE-II协议) 和额外的剂量分配形状特征的目标.
开发了四种定制:一个基线和三个变化,旨在进行梨状剂量分布,并提供一个连续体积优化选项.
该方法在269个支臂疗法分数 (123名患者) 上进行了测试,评估了运行时间,剂量分布和剂量-体积指标,由多学科团队评估临床可接受性.

主要成果:

治疗计划迅速生成,不到2.8分钟 (基线) 和3.7分钟 (连续体积),尽管使用了26万个剂量计算点.
定制制造出了一般形剂量分布,具有临床上可比的剂量体积值;相邻性优化在特定场景中提供了优势.
一个手臂治疗团队在4个测试定制中的3个中发现了对所有6名评估患者至少一个临床上可接受的计划.

结论:

三目标的BRIGHT系统有效地生成临床上可接受的宫癌支臂疗法计划.
该方法的灵活性允许直接定制以满足当地临床偏好并实现所需的剂量分布形状.
这种多功能自动化规划工具产生了与EMBRACE-II协议一致的可比剂量-体积指标.

关键词:

自动化治疗计划自动化治疗计划宫癌手臂疗法宫癌手臂疗法多目标优化多目标优化

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