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Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer

We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate canc...

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Autores principales: Park, Jongmoo, Park, Jaehyeon, Oh, Sean, Yea, Ji Woon, Lee, Jeong Eun, Park, Jae Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432831/
https://www.ncbi.nlm.nih.gov/pubmed/34506581
http://dx.doi.org/10.1371/journal.pone.0257216
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author Park, Jongmoo
Park, Jaehyeon
Oh, Sean
Yea, Ji Woon
Lee, Jeong Eun
Park, Jae Won
author_facet Park, Jongmoo
Park, Jaehyeon
Oh, Sean
Yea, Ji Woon
Lee, Jeong Eun
Park, Jae Won
author_sort Park, Jongmoo
collection PubMed
description We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate cancer who were previously treated on the basis of a VMAT plan. All plans were imported into the Eclipse Treatment Planning System version 15.6, and re-calculation and re-optimization were performed. The MCO plan was then generated. The dosimetric quality of the plans was evaluated using dosimetric parameters and dose indices that account for target coverage and sparing of the organs at risk (OARs). We defined the rectum, bladder, and bilateral femoral heads. The VMAT-MCO plan offers an improvement of gross treatment volume coverage with increased minimal dose and reduced maximal dose. In the planning treatment volume, the D(mean) and better gradient, homogeneity, and conformity indexes improved despite the increasing hot and cold spots. When implemented through the MCO plan, a steeper fall off the adjacent OARs in the overlap area was achieved to obtain lower dose parameters. MCO generated better sparing of the rectum and bladder through a tradeoff of the increasing dose to the bilateral femoral heads within the tolerable dose constraints. Compared with re-optimization and re-calculation, respectively, significant dose reductions were observed in the bladder (241 cGy and 254 cGy; p<0.001) and rectum (474 cGy and 604 cGy, p<0.001) with the MCO. Planning evaluation and dosimetric measurements showed that the VMAT-MCO plan using visualized navigation can provide sparing of OAR doses without compromising the target coverage in the same OAR dose constraints.
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spelling pubmed-84328312021-09-11 Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer Park, Jongmoo Park, Jaehyeon Oh, Sean Yea, Ji Woon Lee, Jeong Eun Park, Jae Won PLoS One Research Article We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate cancer who were previously treated on the basis of a VMAT plan. All plans were imported into the Eclipse Treatment Planning System version 15.6, and re-calculation and re-optimization were performed. The MCO plan was then generated. The dosimetric quality of the plans was evaluated using dosimetric parameters and dose indices that account for target coverage and sparing of the organs at risk (OARs). We defined the rectum, bladder, and bilateral femoral heads. The VMAT-MCO plan offers an improvement of gross treatment volume coverage with increased minimal dose and reduced maximal dose. In the planning treatment volume, the D(mean) and better gradient, homogeneity, and conformity indexes improved despite the increasing hot and cold spots. When implemented through the MCO plan, a steeper fall off the adjacent OARs in the overlap area was achieved to obtain lower dose parameters. MCO generated better sparing of the rectum and bladder through a tradeoff of the increasing dose to the bilateral femoral heads within the tolerable dose constraints. Compared with re-optimization and re-calculation, respectively, significant dose reductions were observed in the bladder (241 cGy and 254 cGy; p<0.001) and rectum (474 cGy and 604 cGy, p<0.001) with the MCO. Planning evaluation and dosimetric measurements showed that the VMAT-MCO plan using visualized navigation can provide sparing of OAR doses without compromising the target coverage in the same OAR dose constraints. Public Library of Science 2021-09-10 /pmc/articles/PMC8432831/ /pubmed/34506581 http://dx.doi.org/10.1371/journal.pone.0257216 Text en © 2021 Park et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Park, Jongmoo
Park, Jaehyeon
Oh, Sean
Yea, Ji Woon
Lee, Jeong Eun
Park, Jae Won
Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title_full Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title_fullStr Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title_full_unstemmed Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title_short Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
title_sort multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432831/
https://www.ncbi.nlm.nih.gov/pubmed/34506581
http://dx.doi.org/10.1371/journal.pone.0257216
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