对胸壁和区域淋巴结辐射的基于知识的治疗计划的开发和评估
Panagiota Galanakou1, Nesrin Dogan1, Stuart E Samuels1
1Department of Radiation Oncology, University of Miami, Miami, USA.
Cureus
|February 9, 2026
概括
胸壁和节点辐射的基于知识的规划 (KBP) 模型为手工计划提供了更好的或可比的剂量测量质量. 这些模型提高了复杂的乳腺癌病例的放射治疗效率和一致性.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 医疗保健中的机器学习
背景情况:
- 基于知识的规划 (KBP) 利用机器学习对先前的放射治疗计划进行利用,以提高治疗效率和一致性.
- 现有的乳腺癌KBP研究往往不包括节点覆盖和侧面性特定的胸壁治疗.
- 卷度调制弧线疗法 (VMAT) 是复杂放射治疗病例的常用技术.
研究的目的:
- 开发和评估使用VMAT进行胸壁和区域节点辐射的左侧,右侧和联合KBP模型.
- 为了比较KBP生成的计划与手工创建的临床计划的剂量测量性能和临床可接受性.
- 评估KBP对目标覆盖,危险器官 (OAR) 节省和交付效率的影响.
主要方法:
- 开发KBP模型,使用47名左侧和44名右侧胸壁患者的回顾性数据进行区域节点辐射.
- 代精制的优化目标包括模型预测,手动和正常组织目标 (NTO).
- 验证的KBP计划与使用剂量计终点 (覆盖率,一致性,同质性,OAR剂量) 和盲目的医生审查的临床计划相比.
主要成果:
- 左侧的KBP计划显著减少了食道和甲状腺的平均剂量;右侧的KBP计划减少了甲状腺和心脏的剂量.
- KBP计划显示了可比或改进的符合性和同质性,其中60-65%实现了目标剂量目标 (D98%).
- 在大多数情况下,盲目的医生审查赞成KBP计划,表明临床可接受性和偏好.
结论:
- 用于VMAT胸壁和节点辐射的侧面性特异和组合KBP模型产生比手工方法剂量度上优越或可比的计划.
- KBP为复杂的乳房和胸壁放射治疗提供了可重现和高效的策略,支持工作流程标准化.
- 对于选定的病例,KBP模型需要最小的细化,为改善放射治疗计划提供了有价值的工具.
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