Introduction
Material and methods
Patients
Target and normal tissue delineation
Planning procedure
Prescribed dose
Structure | Cost Function | Constraints |
---|---|---|
PTV | Target Penalty | Prescription:5000 cGy Minimum Volume:50 % Surface Margin:0.5 cm |
Quadratic Overdose | Maximum Dose:5150 cGy RMS Dose Excess:50 cGy Shrink Margin:0.00 cm | |
Underdose DVH | Objective Dose:4750 cGy Minimum Volume:95 % | |
Coronary Artery | Overdose DVH | Objective Dose:500 cGy Maximum Volume:76 % Shrink Margin:0.5 cm |
Overdose DVH | Objective Dose:1000 cGy Maximum Volume:55 % Shrink MarginL:0.2 cm | |
Overdose DVH | Objective Dose:2000 cGy Maximum Volume:46 % Shrink MarginL:0.1 cm | |
Left Lung | Maximum Dose | Maximum Dose:4950 cGy Shrink Margin:0.8 cm |
Overdose DVH | Objective Dose:500 cGy Maximum Volume:30 % Shrink Margin:0.0 cm Optimize over all voxels in volume | |
Overdose DVH | Objective Dose:1000 cGy Maximum Volume:20 % Shrink Margin:0.0 cm | |
Overdose DVH | Objective Dose:2000 cGy Maximum Volume:15 % Shrink Margin:0.0 cm | |
Heart | Overdose DVH | Objective Dose:3000 cGy Maximum Volume:3 % Shrink Margin:1.0 cm |
Right Breast | Overdose DVH | Objective Dose:500 cGy Maximum Volume:4 % Shrink Margin:0.3 cm |
Right Lung | Overdose DVH | Objective Dose:500 cGy Maximum Volume:6 % Shrink Margin:0.0 cm |
Liver | Maximum Dose | Maximum Dose:1500 cGy Shrink Margin:0.8 cm |
Esophagus | Maximum Dose | Maximum Dose:500 cGy Shrink Margin:0.0 cm |
Spinal cord | Maximum Dose | Maximum Dose:800 cGy Shrink Margin:0.5 cm |
Body | Quadratic Overdose | Maximum Dose:5000 cGy RMS Dose Excess:30 cGy Shrink Margin:0.00 cm |
Quadratic Overdose | Maximum Dose:4500 cGy RMS Dose Excess:40 cGy Shrink Margin:1.00 cm | |
Maximum Dose | Maximum Dose:6050 cGy Shrink Margin:0.00 cm Optimize over all voxels in volume | |
Maximum Dose | Maximum Dose:5600 cGy Shrink Margin:0.50 cm |
Dosimetric evaluation parameters
Plans of quality analysis in population and individual case
Statistics
Results
Dose analysis of planning target volume
2FIMRT | 4FIMRT | 2ArcVMAT | 1ArcVMAT | |
---|---|---|---|---|
D98 (Gy) | 46.2 ± 0.6 A
| 46.4 ± 0.4 | 46.6 ± 0.4 B
| 46.6 ± 0.6 B
|
D50 (Gy) | 50.7 ± 0.5 A
| 50.2 ± 0.3 B,a
| 49.7 ± 0.5 B,b
| 49.7 ± 0.6 B,b
|
D2 (Gy) | 53.8 ± 0.7 A
| 53.5 ± 0.5 A
| 52.5 ± 0.6 B
| 52.5 ± 1.1 |
V107 | 4.6 % ± 5.4 % A
| 2.2 % ± 1.8 % a
| 0.6 % ± 1.1 % B
| 0.7 % ± 0.9 % B,b
|
HI | 0.150 ± 0.022 A
| 0.140 ± 0.016 A
| 0.118 ± 0.018 B
| 0.120 ± 0.029 B
|
CI | 1.34 ± 0.10 A
| 1.32 ± 0.10 A
| 1.24 ± 0.07 B,a
| 1.16 ± 0.05 B,b
|
CN | 0.677 ± 0.050 A
| 0.685 ± 0.051 A
| 0.728 ± 0.036 B,a
| 0.781 ± 0.032 B,b
|
MU | 265.8 ± 15.6 A,b
| 353.1 ± 41.0 A,a
| 494.1 ± 54.5 B,b
| 598.3 ± 93.9 B,a
|
Time (Second) | 115.8 ± 10.0 A
| 206.3 ± 25.0 B,a
| 160.9 ± 17.6 B,b
| 189.1 ± 27.0 B,a
|
MUs and delivery time
Dose analysis of OARs
Structure | Dose parameter | 2FIMRT | 4FIMRT | 2ArcVMAT | 1ArcVMAT |
---|---|---|---|---|---|
Body-PTV | Dmean(Gy) | 2.2 ± 0.7 A
| 2.4 ± 0.7 A
| 2.3 ± 0.7 A
| 2.8 ± 0.8 B
|
ID (Gy*litre) | 43.7 ± 13.5 A
| 48.0 ± 13.9 B,a
| 44.7 ± 13.6 A,a
| 54.5 ± 16.7 B,b
| |
Left Lung | Dmean(Gy) | 4.9 ± 2.4 A
| 5.2 ± 2.1 | 5.0 ± 2.0 A
| 5.4 ± 1.8 B
|
V5 | 16.6 % ± 7.9 % A
| 19.1 % ± 7.7 % B
| 18.4 % ± 7.2 % B,a
| 21.7 % ± 6.9 % B,b
| |
V20 | 9.3 % ± 5.1 % | 9.5 % ± 4.7 % | 9.2 % ± 4.2 % | 9.3 % ± 4.1 % | |
V40 | 4.3 % ± 2.8 % A
| 3.7 % ± 2.3 % B,a
| 3.8 % ± 2.2 % a
| 3.1 % ± 1.9 % B,b
| |
Right lung | Dmean (Gy) | 0.2 ± 0.1 A
| 0.3 ± 0.2 A
| 0.3 ± 0.1 A
| 0.8 ± 0.4 B
|
V5 | 0.0 % ± 0.0 % A
| 0.4 % ± 1.0 % | 0.0 % ± 0.1 % a
| 0.9 % ± 1.5 % B,b
| |
Right breast | Dmean(Gy) | 0.5 ± 0.3 A
| 0.8 ± 0.4 B,a
| 0.9 ± 0.3 B,a
| 1.8 ± 0.8 B,b
|
V5 | 0.1 % ± 0.2 % A
| 1.9 % ± 1.9 % B,a
| 0.6 % ± 1.1 % B,b
| 1.5 % ± 2.3 % B
| |
Esophagus | Dmean(Gy) | 0.3 ± 0.1 A
| 0.4 ± 0.1 A
| 0.4 ± 0.1 A
| 0.7 ± 0.3 B
|
Liver | Dmean(Gy) | 0.2 ± 0.1 A
| 0.2 ± 0.1 A
| 0.3 ± 0.2 A
| 1.0 ± 0.7 B
|
Spinal cord | Dmean(Gy) | 0.1 ± 0.0 A
| 0.2 ± 0.0 A
| 0.2 ± 0.0 A
| 0.4 ± 0.2 B
|
Dose analysis of heart and coronary arteries
Structure | Dose parameter | 2FIMRT | 4FIMRT | 2ArcVMAT | 1ArcVMAT |
---|---|---|---|---|---|
Heart | Dmean(Gy) | 2.8 ± 1.0 A
| 3.0 ± 1.4 a
| 3.3 ± 1.3 B
| 3.7 ± 1.4 B,b
|
Dmax(Gy) | 50.2 ± 2.3 A
| 48.2 ± 3.7 B,a
| 44.1 ± 15.7 | 45.4 ± 5.2 B,b
| |
V5 | 8.6 % ± 3.8 % A
| 11.0 % ± 6.9 % a
| 13.7 % ± 7.0 % B
| 16.6 % ± 9.2 % B,b
| |
V20 | 3.4 % ± 1.7 % A
| 3.3 % ± 2.3 % A
| 3.7 % ± 2.4 % B
| 3.4 % ± 2.6 % A
| |
V40 | 0.9 % ± 0.5 % A
| 0.7 % ± 0.5 % B
| 0.9 % ± 0.6 % a
| 0.4 % ± 0.5 % B,b
| |
CA | Dmean(Gy) | 13.2 ± 3.9 | 13.3 ± 4.0 | 12.7 ± 5.8 | 12.7 ± 4.3 |
Dmax(Gy) | 50.2 ± 1.7 A
| 48.7 ± 3.7 A
| 48.9 ± 5.3 A
| 45.6 ± 4.9 B
| |
V5 | 56.4 % ± 15.4 % A
| 60.8 % ± 16.6 % | 62.1 % ± 18.6 % B
| 62.7 % ± 15.2 % B
| |
V20 | 26.1 % ± 10.5 % | 25.7 % ± 10.9 % | 27.2 % ± 12.3 % A
| 24.8 % ± 13.3 % B
| |
V40 | 7.3 % ± 3.8 % A
| 5.9 % ± 3.5 % A
| 6.8 % ± 4.0 % A
| 3.3 % ± 3.5 % B
| |
Heart-CA | Dmean(Gy) | 1.4 ± 0.5 A
| 1.8 ± 0.9 B,a
| 2.0 ± 0.9 B,a
| 2.5 ± 1.0 B,b
|
V5 | 2.4 % ± 2.0 % A
| 5.6 % ± 5.3 % B,a
| 7.3 % ± 6.1 % B
| 10.5 % ± 8.5 % B,b
| |
V20 | 0.3 % ± 0.6 % | 0.6 % ± 1.2 % | 0.6 % ± 1.2 % | 0.6 % ± 1.1 % | |
V40 | 0.1 % ± 0.2 % | 0.1 % ± 0.2 % | 0.1 % ± 0.2 % | 0.0 % ± 0.1 % |
Plans of quality score
Structure | Dose Parameter | 2 F-IMRT | 4 F-IMRT | 2Arc-VMAT | 1Arc-VMAT |
---|---|---|---|---|---|
PTV | HI | 0 | 0 | 1 | 1 |
CI | 0 | 0 | 1 | 1 | |
CN | 0 | 0 | 1 | 1 | |
MU | 1 | 0 | 0 | 0 | |
Time | 1 | 0 | 0 | 0 | |
Lung.L | Dmean
| 1 | 0 | 1 | 0 |
V5 | 1 | 0 | 1 | 0 | |
V20 | 0 | 0 | 0 | 0 | |
V40 | 0 | 0 | 0 | 1 | |
Heart | Dmean
| 1 | 1 | 0 | 0 |
V5 | 1 | 0 | 0 | 0 | |
V20 | 1 | 1 | 0 | 1 | |
V40 | 0 | 0 | 0 | 1 | |
Coronary artery | Dmean
| 0 | 0 | 0 | 0 |
V5 | 1 | 0 | 0 | 0 | |
V20 | 0 | 0 | 0 | 1 | |
V40 | 0 | 0 | 0 | 1 | |
Healthy tissue | Dmean
| 1 | 1 | 1 | 0 |
Breast.R | Dmean
| 1 | 0 | 0 | 0 |
Liver | Dmean
| 1 | 1 | 1 | 0 |
P-cord | Dmean
| 1 | 1 | 1 | 0 |
Eso | Dmean
| 1 | 1 | 1 | 0 |
Lung.R | Dmean
| 1 | 0 | 1 | 0 |
Total Score | 14 | 6 | 10 | 8 | |
Scores from Heart and CA | 4 | 2 | 0 | 4 |
Structure | Parameter | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | Most Appearance |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PTV | HI | 2A | 2A | 4 F | 2A | 2A | 1A | 1A | 1A | 1A | 2A | 2A | 2A |
CI | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | |
CN | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | 1A | |
MU | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | |
Time | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | |
Lung.L | Dmean
| 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2A | 2 F | 2 F | 1A | 4 F | 2 F |
V5 | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2A | 2A | 2 F | 1A | 4 F | 2 F | |
V20 | 2 F | 2 F | 2A | 2 F | 2 F | 1A | 1A | 2A | 1A | 1A | 4 F | 2 F /1A | |
V40 | 4 F | 1A | 1A | 4 F | 1A | 1A | 1A | 2A | 4 F | 1A | 1A | 1A | |
Heart | Dmean
| 4 F | 2 F | 2 F | 2 F | 2 F | 2 F | 4 F | 2A | 4 F | 1A | 2 F | 2 F |
V5 | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 4 F | 2A | 2 F | 2 F | 2 F | 2 F | |
V20 | 4 F | 4 F | 4 F | 2 F | 4 F | 4 F | 4 F | 2A | 4 F | 1A | 1A | 4 F | |
V40 | 1A | 1A | 1A | 1A | 4 F | 1A | 1A | 1A | 4 F | 1A | 1A | 1A | |
CA | Dmean
| 4 F | 4 F | 1A | 2 F | 4 F | 1A | 1A | 2A | 4 F | 1A | 1A | 1A |
V5 | 2 F | 2 F | 4 F | 2 F | 2 F | 4 F | 2 F | 2A | 4 F | 1A | 4 F | 2 F | |
V20 | 4 F | 4 F | 4 F | 2 F | 4 F | 4 F | 1A | 2A | 4 F | 1A | 1A | 4 F | |
V40 | 4 F | 1A | 1A | 4 F | 1A | 1A | 1A | 1A | 4 F | 1A | 1A | 1A | |
Healthy tissue | Dmean
| 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2A | 2 F | 2A | 2 F | 2 F |
Breast.R | Dmean
| 2 F | 2 F | 2 F | 2 F | 2 F | 4 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F |
Liver | Dmean
| 2A | 2A | 2 F | 2 F | 2 F | 4 F | 2 F | 2A | 2 F | 4 F | 2 F | 2 F |
P-cord | Dmean
| 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 4 F | 2 F | 2 F |
Eso | Dmean
| 2 F | 2 F | 2 F | 2A | 2 F | 2 F | 2 F | 2A | 2 F | 2 F | 2 F | 2 F |
Lung.R | Dmean
| 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F |
Most Appearance | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F | 2 F/1A | 2A | 2 F | 1A | 2 F |