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Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy

BACKGROUND AND PURPOSE: Planning complex radiotherapy treatments can be inefficient, with large variation in plan quality. In this study we evaluated plan quality and planning efficiency using real-time interactive planning (RTIP) for head and neck (HN) volumetric modulated arc therapy (VMAT). MATER...

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Autores principales: Baker, Lindsey, Olson, Robert, Braich, Taran, Koulis, Theodora, Ye, Allison, Ahmed, Nisar, Tran, Eric, Lawyer, Kim, Otto, Karl, Smith, Sally, Mestrovic, Ante, Matthews, Quinn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807618/
https://www.ncbi.nlm.nih.gov/pubmed/33458430
http://dx.doi.org/10.1016/j.phro.2019.03.002
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author Baker, Lindsey
Olson, Robert
Braich, Taran
Koulis, Theodora
Ye, Allison
Ahmed, Nisar
Tran, Eric
Lawyer, Kim
Otto, Karl
Smith, Sally
Mestrovic, Ante
Matthews, Quinn
author_facet Baker, Lindsey
Olson, Robert
Braich, Taran
Koulis, Theodora
Ye, Allison
Ahmed, Nisar
Tran, Eric
Lawyer, Kim
Otto, Karl
Smith, Sally
Mestrovic, Ante
Matthews, Quinn
author_sort Baker, Lindsey
collection PubMed
description BACKGROUND AND PURPOSE: Planning complex radiotherapy treatments can be inefficient, with large variation in plan quality. In this study we evaluated plan quality and planning efficiency using real-time interactive planning (RTIP) for head and neck (HN) volumetric modulated arc therapy (VMAT). MATERIALS AND METHODS: RTIP allows manipulation of dose volume histograms (DVHs) in real-time to assess achievable planning target volume (PTV) coverage and organ at risk (OAR) sparing. For 20 HN patients previously treated with VMAT, RTIP was used to minimize OAR dose while maintaining PTV coverage. RTIP DVHs were used to guide VMAT optimization. Dosimetric differences between RTIP-assisted plans and original clinical plans were assessed. Five blinded radiation oncologists indicated their preference for each PTV, OAR and overall plan. To assess efficiency, ten patients were planned de novo by experienced and novice planners and a RTIP user. RESULTS: The average planning time with RTIP was <20 min, and most plans required only one optimization. All 20 RTIP plans were preferred by a majority of oncologists due to improvements in OAR sparing. The average maximum dose to the spinal cord was reduced by 10.5 Gy (from 49.5 to 39.0 Gy), and the average mean doses for the oral cavity, laryngopharynx, contralateral parotid and submandibular glands were reduced by 3.5 Gy (39.1–35.7 Gy), 6.8 Gy (42.5–35.7 Gy), 1.7 Gy (17.0–15.3 Gy) and 3.3 Gy (22.9–19.5 Gy), respectively. CONCLUSIONS: Incorporating RTIP into clinical workflows may increase both planning efficiency and OAR sparing.
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spelling pubmed-78076182021-01-14 Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy Baker, Lindsey Olson, Robert Braich, Taran Koulis, Theodora Ye, Allison Ahmed, Nisar Tran, Eric Lawyer, Kim Otto, Karl Smith, Sally Mestrovic, Ante Matthews, Quinn Phys Imaging Radiat Oncol Original Research Article BACKGROUND AND PURPOSE: Planning complex radiotherapy treatments can be inefficient, with large variation in plan quality. In this study we evaluated plan quality and planning efficiency using real-time interactive planning (RTIP) for head and neck (HN) volumetric modulated arc therapy (VMAT). MATERIALS AND METHODS: RTIP allows manipulation of dose volume histograms (DVHs) in real-time to assess achievable planning target volume (PTV) coverage and organ at risk (OAR) sparing. For 20 HN patients previously treated with VMAT, RTIP was used to minimize OAR dose while maintaining PTV coverage. RTIP DVHs were used to guide VMAT optimization. Dosimetric differences between RTIP-assisted plans and original clinical plans were assessed. Five blinded radiation oncologists indicated their preference for each PTV, OAR and overall plan. To assess efficiency, ten patients were planned de novo by experienced and novice planners and a RTIP user. RESULTS: The average planning time with RTIP was <20 min, and most plans required only one optimization. All 20 RTIP plans were preferred by a majority of oncologists due to improvements in OAR sparing. The average maximum dose to the spinal cord was reduced by 10.5 Gy (from 49.5 to 39.0 Gy), and the average mean doses for the oral cavity, laryngopharynx, contralateral parotid and submandibular glands were reduced by 3.5 Gy (39.1–35.7 Gy), 6.8 Gy (42.5–35.7 Gy), 1.7 Gy (17.0–15.3 Gy) and 3.3 Gy (22.9–19.5 Gy), respectively. CONCLUSIONS: Incorporating RTIP into clinical workflows may increase both planning efficiency and OAR sparing. Elsevier 2019-04-04 /pmc/articles/PMC7807618/ /pubmed/33458430 http://dx.doi.org/10.1016/j.phro.2019.03.002 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research Article
Baker, Lindsey
Olson, Robert
Braich, Taran
Koulis, Theodora
Ye, Allison
Ahmed, Nisar
Tran, Eric
Lawyer, Kim
Otto, Karl
Smith, Sally
Mestrovic, Ante
Matthews, Quinn
Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title_full Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title_fullStr Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title_full_unstemmed Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title_short Real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
title_sort real-time interactive planning for radiotherapy of head and neck cancer with volumetric modulated arc therapy
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807618/
https://www.ncbi.nlm.nih.gov/pubmed/33458430
http://dx.doi.org/10.1016/j.phro.2019.03.002
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