Results of quality assessments for APs and MPs.

PurposeThis study aims to develop a fully automated VMAT planning program for short-course radiotherapy (SCRT) in Locally Advanced Rectal Cancer (LARC) and assess its plan quality, feasibility, and efficiency.Materials and methodsThirty LARC patients who underwent short-course VMAT treatment were retrospectively selected from our institution for this study. An auto-planning program for neoadjuvant short-course radiotherapy (SCRT) in LARC was developed using the RayStation scripting platform integrated with the Python environment. The patients were re-planned using this auto-planning program. Subsequently, the differences between the automatic plans (APs) and existing manual plans (MPs) were compared in terms of plan quality, monitor units (MU), plan complexity, and other dosimetric parameters. Plan quality assurance (QA) was performed using the ArcCHECK dosimetric verification system.ResultsCompared to MPs, the APs achieved similar target coverage and conformity, while providing more rapid dose fall-off. Except for the V5Gy dose level, other dosimetric metrics (V25 Gy, V23 Gy, V15 Gy, Dmean, etc.) for the small bowel were significantly lower in the AP compared to the MP (p ConclusionWe developed a fully automated, feasible SCRT VMAT planning program for LARC. This program significantly enhanced plan quality and efficiency while substantially reducing the dose to OARs.研究目的 本研究旨在开发一款针对局部晚期直肠癌（Locally Advanced Rectal Cancer, LARC）短程放疗（short-course radiotherapy, SCRT）的全自动化容积调强弧形治疗（Volumetric Modulated Arc Therapy, VMAT）计划系统，并评估其计划质量、可行性与效率。 材料与方法 本研究回顾性选取本机构30例接受短程VMAT治疗的LARC患者。依托集成Python环境的RayStation脚本平台，开发针对LARC新辅助短程放疗（SCRT）的自动计划系统。使用该自动计划系统对入组患者进行重新计划，随后从计划质量、机器跳数（monitor units, MU）、计划复杂度及其他剂量学参数等维度，对比自动计划（automatic plans, APs）与现有手动计划（manual plans, MPs）的差异。采用ArcCHECK剂量验证系统开展计划质量保证（QA）工作。 结果 相较于手动计划，自动计划在靶区覆盖度与适形度方面表现相当，且具备更快速的剂量跌落特性。除V5Gy剂量水平外，自动计划组小肠的其余剂量学指标（V25Gy、V23Gy、V15Gy、平均剂量Dmean等）均显著低于手动计划组（p 结论 本研究开发了一款针对LARC的全自动化、可行性良好的短程放疗VMAT计划系统。该系统可显著提升计划质量与效率，并大幅降低危及器官（organs at risk, OARs）所受辐射剂量。