Development of advanced preselection tools to reduce redundant plan comparisons in model-based selection of head and neck cancer patients for proton therapy
| Autor: | E. Oldehinkel, Hans Paul van der Laan, J. Free, Wouter Rutgers, Tineke W.H. Meijer, Arjen van der Schaaf, D. Scandurra, Stefan Both, Makbule Tambas, Johanna G M van den Hoek, Johannes A. Langendijk, Roel J H M Steenbakkers |
|---|---|
| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Rok vydání: | 2021 |
| Předmět: |
Organs at Risk
medicine.medical_specialty TUBE-FEEDING DEPENDENCE IMPACT IMPT medicine.medical_treatment Normal tissue 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Patient selection TREATMENT TIME medicine Humans Plan comparison Radiology Nuclear Medicine and imaging Medical physics Prospective Studies Head and neck cancer OPTIMIZATION Prospective cohort study Proton therapy Selection (genetic algorithm) Netherlands business.industry Radiotherapy Planning Computer-Assisted ORGAN Volumetric data Radiotherapy Dosage Hematology medicine.disease Preselection Predictive value Radiation therapy Oncology Head and Neck Neoplasms 030220 oncology & carcinogenesis SURVIVAL Radiotherapy Intensity-Modulated business RADIOTHERAPY |
| Zdroj: | Radiotherapy and Oncology Radiotherapy and Oncology, 160, 61-68. ELSEVIER IRELAND LTD |
| ISSN: | 0167-8140 |
| Popis: | PURPOSE: In the Netherlands, head and neck cancer (HNC) patients are selected for proton therapy (PT) based on estimated normal tissue complication probability differences (ΔNTCP) between photons and protons, which requires a plan comparison (VMAT vs. IMPT). We aimed to develop tools to improve patient selection for plan comparisons.METHODS: This prospective study consisted of 141 consecutive patients in which a plan comparison was done. IMPT plans of patients not qualifying for PT were classified as 'redundant'. To prevent redundant IMPT planning, 5 methods that were primarily based on regression models were developed to predict IMPT Dmean to OARs, by using data from VMAT plans and volumetric data from delineated targets and OARs. Then, actual and predicted plan comparison outcomes were compared. The endpoint was being selected for proton therapy.RESULTS: Seventy out of 141 patients (49.6%) qualified for PT. Using the developed preselection tools, redundant IMPT planning could have been prevented in 49-68% of the remaining 71 patients not qualifying for PT (=specificity) when the sensitivity of all methods was fixed to 100%, i.e., no false negative cases (positive predictive value range: 57-68%, negative predictive value: 100%).CONCLUSION: The advanced preselection tools, which uses volume and VMAT dose data, prevented labour intensive creation of IMPT plans in up to 68% of non-qualifying patients for PT. No patients qualifying for PT would have been incorrectly denied a plan comparison. This method contributes significantly to a more cost-effective model-based selection of HNC patients for PT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect