Toward Fully Automated Multicriterial Plan Generation: A Prospective Clinical Study
| Autor: | D. Fransen, Maarten L.P. Dirkx, Ben J.M. Heijmen, Sebastiaan Breedveld, Peter W.J. Voet, Peter C. Levendag |
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| Přispěvatelé: | Radiotherapy |
| Rok vydání: | 2013 |
| Předmět: |
Organs at Risk
Cancer Research medicine.medical_specialty Sialography medicine.medical_treatment Planning target volume Plan (drawing) Oral cavity Esophagus medicine Humans Radiology Nuclear Medicine and imaging Medical physics Prospective Studies Patient group Radiation Injuries Mouth Radiation business.industry Radiotherapy Planning Computer-Assisted Radiation therapy Oncology Fully automated Head and Neck Neoplasms Prospective clinical study Dose reduction Radiotherapy Intensity-Modulated Laryngeal Muscles Larynx business Organ Sparing Treatments Algorithms |
| Zdroj: | International Journal of Radiation Oncology Biology Physics, 85(3), 866-872. Elsevier Inc. |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2012.04.015 |
| Popis: | Purpose To prospectively compare plans generated with iCycle, an in-house-developed algorithm for fully automated multicriterial intensity modulated radiation therapy (IMRT) beam profile and beam orientation optimization, with plans manually generated by dosimetrists using the clinical treatment planning system. Methods and Materials For 20 randomly selected head-and-neck cancer patients with various tumor locations (of whom 13 received sequential boost treatments), we offered the treating physician the choice between an automatically generated iCycle plan and a manually optimized plan using standard clinical procedures. Although iCycle used a fixed “wish list” with hard constraints and prioritized objectives, the dosimetrists manually selected the beam configuration and fine tuned the constraints and objectives for each IMRT plan. Dosimetrists were not informed in advance whether a competing iCycle plan was made. The 2 plans were simultaneously presented to the physician, who then selected the plan to be used for treatment. For the patient group, differences in planning target volume coverage and sparing of critical tissues were quantified. Results In 32 of 33 plan comparisons, the physician selected the iCycle plan for treatment. This highly consistent preference for the automatically generated plans was mainly caused by the improved sparing for the large majority of critical structures. With iCycle, the normal tissue complication probabilities for the parotid and submandibular glands were reduced by 2.4% ± 4.9% (maximum, 18.5%, P =.001) and 6.5% ± 8.3% (maximum, 27%, P =.005), respectively. The reduction in the mean oral cavity dose was 2.8 ± 2.8 Gy (maximum, 8.1 Gy, P =.005). For the swallowing muscles, the esophagus and larynx, the mean dose reduction was 3.3 ± 1.1 Gy (maximum, 9.2 Gy, P Conclusions In 97% of cases, automatically generated plans were selected for treatment because of the superior quality. Apart from the improved plan quality, automatic plan generation is economically attractive because of the reduced workload. |
| Databáze: | OpenAIRE |
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