Evaluating the application of Pareto navigation guided automated radiotherapy treatment planning to prostate cancer.

Autor: Wheeler PA; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom. Electronic address: philip.wheeler@wales.nhs.uk., Chu M; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Holmes R; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Woodley OW; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Jones CS; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Maggs R; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Staffurth J; School of Medicine, Cardiff University, Cardiff, United Kingdom., Palaniappan N; Department of Oncology, Velindre Cancer Centre, Cardiff, United Kingdom., Spezi E; School of Engineering, Cardiff University, Cardiff, United Kingdom., Lewis DG; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom., Campbell S; Velindre Cancer Centre, Cardiff, United Kingdom., Fitzgibbon J; Wales Cancer Research Centre, Cardiff, United Kingdom., Millin AE; Department of Medical Physics, Velindre Cancer Centre, Cardiff, United Kingdom.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2019 Dec; Vol. 141, pp. 220-226. Date of Electronic Publication: 2019 Sep 13.
DOI: 10.1016/j.radonc.2019.08.001
Abstrakt: Background and Purpose: Current automated planning methods do not allow for the intuitive exploration of clinical trade-offs during calibration. Recently a novel automated planning solution, which is calibrated using Pareto navigation principles, has been developed to address this issue. The purpose of this work was to clinically validate the solution for prostate cancer patients with and without elective nodal irradiation.
Materials and Methods: For 40 randomly selected patients (20 prostate and seminal vesicles (PSV) and 20 prostate and pelvic nodes (PPN)) automatically generated volumetric modulated arc therapy plans (VMAT Auto ) were compared against plans created by expert dosimetrists under clinical conditions (VMAT Clinical ) and no time pressures (VMAT Ideal ). Plans were compared through quantitative comparison of dosimetric parameters and blind review by an oncologist.
Results: Upon blind review 39/40 and 33/40 VMAT Auto plans were considered preferable or equal to VMAT Clinical and VMAT Ideal respectively, with all deemed clinically acceptable. Dosimetrically, VMAT Auto , VMAT Clinical and VMAT Ideal were similar, with observed differences generally of low clinical significance. Compared to VMAT Clinical , VMAT Auto reduced hands-on planning time by 94% and 79% for PSV and PPN respectively. Total planning time was significantly reduced from 22.2 mins to 14.0 mins for PSV, with no significant reduction observed for PPN.
Conclusions: A novel automated planning solution has been evaluated, whose Pareto navigation based calibration enabled clinical decision-making on trade-off balancing to be intuitively incorporated into automated protocols. It was successfully applied to two sites of differing complexity and robustly generated high quality plans in an efficient manner.
(Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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