臺灣博碩士論文加值系統

目的：為了提升在放射治療計畫研究對於正常組織併發症機率(normal tissue complication probability, NTCP)與腫瘤控制率(tumor control probability, TCP) 不同模型的評估效率，本研究建構創新放射治療計畫整合分析平台，提供更簡便的TCP/NTCP數據研究工具。
材料與方法：本研究利用MatLab軟體設計開發可應用於一般個人電腦使用的多功能放射治療計畫分析平台，平台中包括2個主要部分：劑量-體積直方圖(dose-volume histogram, DVH)繪製與NTCP/TCP計算。匯入從治療計畫系統 (Philips Pinnacle)輸出的資料，在平台介面中重現DVH圖形，取得研究所需的相關數據，同時進行NTCP/TCP的計算。本研究以32個鼻咽癌強度調控放射治療計畫輸出資料，利用本平台取得數據與人工檢閱方式及治療計畫系統取得的數據加以比較，驗證本分析平台的正確性。
結果：本研究成功開發出劑量-體積直方圖、正常組織併發症機率與腫瘤控制率分析平台，在DVH的驗證結果中，人工檢閱的部份誤差小於± 0.00%，治療計畫系統 (Philips Pinnacle)的誤差則小於± 1.20%；而在NTCP/TCP/EUD的驗證結果中，人工檢閱的部份誤差小於± 0.64%，治療計畫系統 (Philips Pinnacle)的誤差則小於± 1.51%，驗證結果在臨床可接受之誤差範圍內。
結論：本研究所設計開發出放射治療計畫正常組織併發症機率與腫瘤控制率分析平台，具有快速、簡便、價格低廉的優勢，幫助研究的進行，然而是否能供臨床實際應用，仍須進一步探討。

Purpose: To improve the investigation processing efficiency for the radiation therapy treatment planning evaluation for the normal tissue complication probability (NTCP) and tumor control probability (TCP) in different models, we construct an innovative platform that provides a more convenient environment for TCP/NTCP study.
Materials and methods: We developed a multi-functional platform by using MatLab software that could be run in a personal computer. The platform includes two parts: dose-volume histogram (DVH) plot and NTCP/TCP calculation. DVH data can be imported by the user from a treatment planning system (TPS) into the platform and then to proceed DVH plotting, NTCP/TCP calculation, and get the research information friendly. For the platform performance validation, a total of 32 IMRT plans for patients with nasopharyngeal cancer were selected to test.
Results: We compared the processing results from platform and TPS itself. The validation result shows that the accuracy is clinically acceptable. For DVH evaluation, the difference is ± 0.00% by manual review; while the system difference is ± 1.2% for the TPS. For NTCP/TCP and EUD evaluation, the difference is ± 0.64% for manual review; while the difference is ± 1.51% for the TPS.
Conclusion: We found that our radiotherapy analytic platform is user friendly, easy to use, and can provide a convenient and cheaper environment for TCP/NTCP study. Whether such superiority in planning investigation could transfer into clinical advantages needs further study.

目錄
摘要 i
Abstract iii
致謝 v
目錄 vi
表目錄 viii
圖目錄 ix
縮寫符號 xi
第一章 緒論 1
1.1 動機 1
1.2 目的 2
1.3 相關文獻探討 3
1.4 研究章節架構 4
第二章 材料與方法 5
2.1 前言 5
2.2 放射治療技術 6
2.2.1 治療計畫技術 6
2.2.1.1 強度調控放射治療計畫 6
2.2.1.2 治療區域規畫 7
2.2.2 劑量-體積直方圖 9
2.2.3 等效均勻劑量 11
2.2.3.1 不同a值的變化對應到EUD值 12
2.2.3.2 生物等效劑量 14
2.2.3.3 mEUD與gEUD的差異 15
2.2.4 正常組織併發症機率 17
2.2.4.1 Lyman NTCP 模型 17
2.2.4.2 Logistic模型 18
2.2.5 腫瘤控制率 18
2.2.6 Pinnacle治療計畫系統NTCP/TCP評估工具 19
2.3 MatLab 20
2.3.1 GUI開發 22
2.4 平台驗證 25
2.4.1 驗證資料 25
2.4.2 驗證流程 25
2.4.3 統計方法 26
第三章 結果 27
3.1 前言 27
3.2 輸入資料 28
3.3 劑量-體積直方圖 (DVH)介面 30
3.4 劑量參數 34
3.5 NTCP/TCP操作介面 37
3.6 平台數據驗證 42
3.6.1 DVH平台數據驗證 42
3.6.2 NTCP數據驗證 44
3.6.3 TCP數據驗證 46
第四章 討論 48
4.1 平台驗證結果討論 48
4.2 相關研究文獻比較 49
4.3 本研究的優點 50
4.4 限制性 51
第五章 結論 53
5.1 結論 53
5.2 未來展望 53
參考文獻 54
自傳 61

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