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Abstract：
OBJECTIVE: To determine the dosimetric differences between biological and physical functions of equivalent uniform dose (EUD) and dose volume (DV) therapy in patients with phase III non-small cell lung cancer.
METHODS: Four different radiotherapy plans (DV+DV, DV-EUD+DV, EUD+EUD and EUD-DV+EUD) were developed for 15 patients with stage III NSCLC. To study physical function (DV+DV) the target area was optimized by introducing the conditions of biological function optimization, while the organs at risk were optimized by means of physical function (DV-EUD+DV). Biological function optimization (EUD+EUD) was performed for the target area by applying conditions of physical function optimization while biological function optimization (EUD-DV+DV) was conducted for the organs at risk to compare dosimetric parameters among the four groups of treatment plans.
RESULTS: PTV: D2%, D98%, D50%, V105% and Dmax of both the DV-EUD+DV group and EDU-DV+EUD group were the minimum (P<0.05). The minimum and average dose of the EUD+EUD group showed an increasing trend and high-dose area became observable. For homogeneity index (HI), DV-EUD+DV group and EUD-DV+EUD results were compared with the other groups (P<0.05), no significant difference was observed statistically between the DV-EUD+DV group and EUD DV+EUD (P=0.659). With regard to conformability index (CI), the results of the four groups showed no significant difference (P>0.05). For the organs at risk, the mean dose of lung tissue (MLD), V5, V10, V20, V30, heart V30, V40, and Dmean also revealed no significant difference (P>0.05). For the spinal cord, the D1 % of the EUD+EUD group and EUD-DV+EUD groups were significantly different (P<0.05) than the other groups. While no significant difference (P=0.32) was found between the EUD+EUD and EUD-DV+EUD groups. When comparing the number of machine unions (MU) no significant difference was revealed (P>0.05) among the results of the 4 groups.
CONCLUSIONS: The methods featuring optimization of physical and biological functions are effective in improving the uniformity of target area to have better outcome of the treatment. Biological function optimization or the combination of biological and physical function optimization is conducive to significantly reduce the required dose for the spinal cord.
METHODS: Four different radiotherapy plans (DV+DV, DV-EUD+DV, EUD+EUD and EUD-DV+EUD) were developed for 15 patients with stage III NSCLC. To study physical function (DV+DV) the target area was optimized by introducing the conditions of biological function optimization, while the organs at risk were optimized by means of physical function (DV-EUD+DV). Biological function optimization (EUD+EUD) was performed for the target area by applying conditions of physical function optimization while biological function optimization (EUD-DV+DV) was conducted for the organs at risk to compare dosimetric parameters among the four groups of treatment plans.
RESULTS: PTV: D2%, D98%, D50%, V105% and Dmax of both the DV-EUD+DV group and EDU-DV+EUD group were the minimum (P<0.05). The minimum and average dose of the EUD+EUD group showed an increasing trend and high-dose area became observable. For homogeneity index (HI), DV-EUD+DV group and EUD-DV+EUD results were compared with the other groups (P<0.05), no significant difference was observed statistically between the DV-EUD+DV group and EUD DV+EUD (P=0.659). With regard to conformability index (CI), the results of the four groups showed no significant difference (P>0.05). For the organs at risk, the mean dose of lung tissue (MLD), V5, V10, V20, V30, heart V30, V40, and Dmean also revealed no significant difference (P>0.05). For the spinal cord, the D1 % of the EUD+EUD group and EUD-DV+EUD groups were significantly different (P<0.05) than the other groups. While no significant difference (P=0.32) was found between the EUD+EUD and EUD-DV+EUD groups. When comparing the number of machine unions (MU) no significant difference was revealed (P>0.05) among the results of the 4 groups.
CONCLUSIONS: The methods featuring optimization of physical and biological functions are effective in improving the uniformity of target area to have better outcome of the treatment. Biological function optimization or the combination of biological and physical function optimization is conducive to significantly reduce the required dose for the spinal cord.
摘要：
目的：确定III期非小细胞肺癌患者等效均匀剂量（EUD）和剂量体积（DV）治疗的生物学和物理功能之间的剂量学差异。
方法：四种不同的放疗计划（DV+DV，DV-EUD+DV,EUD+EUD和EUD-DV+EUD）用于15例III期NSCLC患者。为了研究身体功能（DVDV），通过引入生物功能优化的条件来优化目标区域，而有风险的器官通过身体功能（DV-EUD+DV）进行优化。通过应用物理功能优化条件对目标区域进行生物功能优化（EUD+EUD），同时对危险器官进行生物功能优化（EUD-DV+DV），以比较四组治疗计划中的剂量学参数。
结果：PTV：D2%，D98%,D50%,DV-EUD+DV组和EDU-DV+EUD组的V105%和Dmax最小(P<0.05)。EUD+EUD组的最小和平均剂量呈现增加趋势,并且高剂量区域变得可观察到。对于均匀性指数(HI)，DV-EUD+DV组和EUD-DV+EUD结果与其他组比较(P<0.05),DV-EUD+DV组与EUD+EUD组比较差异无统计学意义(P=0.659)。关于一致性指数(CI)，四组结果比较差异无统计学意义(P>0.05)。对于处于危险中的器官，肺组织的平均剂量（MLD），V5，V10，V20，V30，心脏V30，V40和Dmean也没有显着差异（P>0.05）。对于脊髓，EUD+EUD组和EUD-DV+EUD组的D1%与其他组比较差异有统计学意义(P<0.05)。EUD+EUD组和EUD-DV+EUD组之间无显著差异(P=0.32)。当比较机器工会（MU）的数量时，4组结果之间没有显着差异（P>0.05）。
结论：以物理和生物学功能优化为特征的方法可有效改善目标区域的均匀性，从而获得更好的治疗效果。生物功能优化或生物和物理功能优化的结合有利于显著降低脊髓所需剂量。
方法：四种不同的放疗计划（DV+DV，DV-EUD+DV,EUD+EUD和EUD-DV+EUD）用于15例III期NSCLC患者。为了研究身体功能（DVDV），通过引入生物功能优化的条件来优化目标区域，而有风险的器官通过身体功能（DV-EUD+DV）进行优化。通过应用物理功能优化条件对目标区域进行生物功能优化（EUD+EUD），同时对危险器官进行生物功能优化（EUD-DV+DV），以比较四组治疗计划中的剂量学参数。
结果：PTV：D2%，D98%,D50%,DV-EUD+DV组和EDU-DV+EUD组的V105%和Dmax最小(P<0.05)。EUD+EUD组的最小和平均剂量呈现增加趋势,并且高剂量区域变得可观察到。对于均匀性指数(HI)，DV-EUD+DV组和EUD-DV+EUD结果与其他组比较(P<0.05),DV-EUD+DV组与EUD+EUD组比较差异无统计学意义(P=0.659)。关于一致性指数(CI)，四组结果比较差异无统计学意义(P>0.05)。对于处于危险中的器官，肺组织的平均剂量（MLD），V5，V10，V20，V30，心脏V30，V40和Dmean也没有显着差异（P>0.05）。对于脊髓，EUD+EUD组和EUD-DV+EUD组的D1%与其他组比较差异有统计学意义(P<0.05)。EUD+EUD组和EUD-DV+EUD组之间无显著差异(P=0.32)。当比较机器工会（MU）的数量时，4组结果之间没有显着差异（P>0.05）。
结论：以物理和生物学功能优化为特征的方法可有效改善目标区域的均匀性，从而获得更好的治疗效果。生物功能优化或生物和物理功能优化的结合有利于显著降低脊髓所需剂量。
