On the necessity of specialized knowledge-based models for SBRT prostate treatments plans.

Autor: Scaggion A; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy. Electronic address: alessandro.scaggion@iov.veneto.it., Cavinato S; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Dusi F; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., El Khouzai B; S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Guida F; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Paronetto C; S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Rossato MA; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Sapignoli S; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Scott ASA; National Cancer Treatment Centre, Cornwall Regional Hospital, Montego Bay, Jamaica., Sepulcri M; S.C. Radioterapia, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy., Paiusco M; S.C. Fisica Sanitaria, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Jazyk: angličtina
Zdroj: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) [Phys Med] 2024 May; Vol. 121, pp. 103364. Date of Electronic Publication: 2024 May 02.
DOI: 10.1016/j.ejmp.2024.103364
Abstrakt: Purpose: Test whether a well-grounded KBP model trained on moderately hypo-fractionated prostate treatments can be used to satisfactorily drive the optimization of SBRT prostate treatments.
Materials and Methods: A KBP model (SBRT-model) was developed, trained and validated using the first forty-seven clinically treated VMAT SBRT prostate plans (42.7 Gy/7fx or 36.25 Gy/5fx). The performance and robustness of this model were compared against a high-quality KBP-model (ST-model) that was already clinically adopted for hypo-fractionated (70 Gy/28fx and 60 Gy/20fx) prostate treatments. The two models were compared in terms of their predictions robustness, and the quality of their outcomes were evaluated against a set of reference clinical SBRT plans. Plan quality was assessed using DVH metrics, blinded clinical ranking, and a dedicated Plan Quality Metric algorithm.
Results: The plan libraries of the two models were found to share a high degree of anatomical similarity. The overall quality (APQM%) of the plans obtained both with the ST- and SBRT-models was compatible with that of the original clinical plans, namely (93.7 ± 4.1)% and (91.6 ± 3.9)% vs (92.8.9 ± 3.6)%. Plans obtained with the ST-model showed significantly higher target coverage (PTV V95%): (97.9 ± 0.8)% vs (97.1 ± 0.9)% (p < 0.05). Conversely, plans optimized following the SBRT-model showed a small but not-clinically relevant increase in OAR sparing. ST-model generally provided more reliable predictions than SBRT-model. Two radiation oncologists judged as equivalent the plans based on the KBP prediction, which was also judged better that reference clinical plans.
Conclusion: A KBP model trained on moderately fractionated prostate treatment plans provided optimal SBRT prostate plans, with similar or larger plan quality than an embryonic SBRT-model based on a limited number of cases.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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