Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis
| Autor: | François Bochud, Raphaël Moeckli, E. Ozsahin, Kristoffer Petersson, Jean Bourhis, Archonteia Kyroudi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Trade-offs
lcsh:Medical physics. Medical radiology. Nuclear medicine medicine.medical_specialty Computer science Pareto fronts medicine.medical_treatment lcsh:R895-920 Multi-objective optimization lcsh:RC254-282 030218 nuclear medicine & medical imaging CGA 03 medical and health sciences Prostate cancer 0302 clinical medicine medicine Radiology Nuclear Medicine and imaging Medical physics Original Research Article Radiation treatment planning Grading (tumors) Radiation Pareto principle Prostate Radiotherapy treatment planning medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens 3. Good health Radiation therapy 030220 oncology & carcinogenesis Organ at risk Clinical decision making |
| Zdroj: | Physics and Imaging in Radiation Oncology, Vol 14, Iss, Pp 82-86 (2020) Physics and Imaging in Radiation Oncology Physics and imaging in radiation oncology, vol. 14, pp. 82-86 |
| ISSN: | 2405-6316 |
| Popis: | Introduction Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers). We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. Methods and materials Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. Results The plans in the central region of the Pareto front (1–4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5–4% PTV under-dosage) while medical physicists preferred better PTV coverage (1–2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5–1% PTV under-dosage). Conclusion We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them. |
| Databáze: | OpenAIRE |
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