| Summary: | 博士 === 國立高雄應用科技大學 === 電機工程系博碩士班 === 103 === Purpose:
To assist the clinical decision making, we aim to develop a radiotherapy treatment planning clinical decision support system. We quantify the influence parameters for different radiotherapy techniques through Taguchi analytic method to investigate the optimal techniques by these parameters in different kind of breast cancer. We also develop an analytic normal tissue complication probability platform for planning evaluation.
Materials and Methods:
In total 20 early stage breast cancer patients (10-right and 10- left) were enrolled. Five different treatment techniques were used i.e. wedged-tangential fields (WT), intensity modulated radiation therapy (IMRT), hybrid IMRT (H-IMRT), volumetric modulated arc therapy (VMAT), and an innovative hybrid VMAT (H-VMAT) technique we proposed. Using the Taguchi analysis method to analysis the optimal influence parameters for corresponding technique with modified planning quality index (mPQI). With the optimal influence parameters, we compared different techniques in different breast cancer patients. In sequential right or left breast cancer, WT, IMRT, H-IMRT, VMAT and H-VMAT techniques comparison were made. In simultaneous integrated boost right or left breast cancers, IMRT, H-IMRT, VMAT and H-VMAT techniques comparison were done. In bilateral breast cancers, IMRT and VMAT have been compared. We use multiple quantitative indices, including conformity index (CI), homogeneity index(HI), modified planning quality index (mPQI), equivalent uniform dose (EUD), tumor control probability (TCP), normal tissue complication probability (NTCP), to evaluate these techniques for seeking the optimal techniques in different breast cancer treatment for clinical decision support.delivery efficiency.
Results:
By using Taguchi analysis method, there are different dominant control parameters in different techniques for breast cancers. The forward adjust process is needed to get better plan quality in WT. 6MV photon energy are suitable in H-IMRT technique in left sequencial mode (SQM) patients and VMAT technique in right SQM patients.
For the comparison of 5 techniques in SQM breast cancer, all plans can achieve > 95% coverage in planning target volume (PTV), and the organ at risks (OARs) are better sparing in VMAT technique. For the comparison of 4 techniques in simultaneous integrated boost (SIB) breast cancer, the organ at risk is better sparing in VMAT technique. In bilateral breast cancer patients, VMAT technique has better dosimetric results in PTV or OARs.
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