OBJECTIVE:To evaluate dose differences predicted between using Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) in patients diagnosed with locally advanced non-small cell lung cancer (NSCLC) treated with intensity modulated radiation therapy (IMRT). METHODS:A phantom study was done to evaluate the dose prediction accuracy of AXB and AAA beyond low-density medium by comparing the calculated measurement results. Thirty-two advanced NSCLC patients were subjected to IMRT. The dose regimen was 60 Gy over 30 fractions. Effects on planning target volume (PTV) and organ-at-risk (OAR) were evaluated. Clinically acceptable treatment plans with AAA were re-calculated using AXB algorithms with two modes Dw and Dm at the same beam arrangements and multileaf collimator leaf settings as with AAA. RESULTS:Using AXB yielded better agreement with the measurements and the average dose difference for all points was about 0.5%. Conversely, using AAA showed a larger disagreement with measured values and the average difference was up to 5.9%. The maximum relative difference was between AXB_Dm and AAA for PTV dose (D98 %). The percentage dose differences of plans calculated by AAA, AXB_Dw and AAA, AXB_Dm revealed that AAA overestimated the dose than AXB. Regarding OAR, results showed significant difference for lungs-PTV. CONCLUSIONS:AXB algorithm yields more accurate dose prediction than AAA in heterogeneous medium. Differences in dose distribution are observed when plans re-calculated with AXB indicating that AAA apparently overestimates dose, particularly the PTV dose. Thus, AXB algorithm should be used in preference to AAA for cases in which PTVs are involved with tissues of highly different densities, such as lung.

中文翻译：

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各向异性分析算法和 Acuros XB 剂量计算算法对肺癌患者调强放射治疗的临床影响

目的：评估使用各向异性分析算法 (AAA) 和 Acuros XB (AXB) 在接受调强放射治疗 (IMRT) 治疗的局部晚期非小细胞肺癌 (NSCLC) 患者中预测的剂量差异。方法：进行体模研究，通过比较计算的测量结果，评估 AXB 和 AAA 在低密度介质之外的剂量预测准确性。32 名晚期 NSCLC 患者接受了 IMRT。剂量方案为 60 Gy，分 30 次。评估了对计划目标体积 (PTV) 和风险器官 (OAR) 的影响。使用 AXB 算法重新计算临床上可接受的 AAA 治疗计划，具有与 AAA 相同的光束布置和多叶准直器叶片设置的两种模式 Dw 和 Dm。结果：使用 AXB 与测量结果有更好的一致性，所有点的平均剂量差异约为 0.5%。相反，使用 AAA 与测量值的差异更大，平均差异高达 5.9%。PTV 剂量的最大相对差异是 AXB_Dm 和 AAA (D98 %)。由 AAA, AXB_Dw 和 AAA, AXB_Dm 计算的计划的百分比剂量差异表明 AAA 高估了剂量而不是 AXB。关于 OAR，结果显示肺 PTV 存在显着差异。结论：AXB 算法在异质介质中产生比 AAA 更准确的剂量预测。当使用 AXB 重新计算计划时观察到剂量分布的差异，表明 AAA 明显高估了剂量，特别是 PTV 剂量。因此，