Knowledge-based radiation therapy (KBRT) treatment planning versus planning by experts: validation of a KBRT algorithm for prostate cancer treatment planning

Radiation Oncology

Gerhard Glatting²  Frederik Wenz¹  Dwi Seno Kuncoro Sihono¹  Hana Mekdash¹  Obioma Nwankwo² 

[1] Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

关键词: Normal tissue sparing;    Treatment plan optimization;    Dose prediction algorithm;    Personalized radiotherapy treatment planning;    Knowledge-based radiation therapy (KBRT) treatment planning;   

Others  :  1226191
DOI  :  10.1186/s13014-015-0416-6

 received in 2015-04-20, accepted in 2015-04-30,  发布年份 2015

【 摘 要 】

Background

A knowledge-based radiation therapy (KBRT) treatment planning algorithm was recently developed. The purpose of this work is to investigate how plans that are generated with the objective KBRT approach compare to those that rely on the judgment of the experienced planner.

Methods

Thirty volumetric modulated arc therapy plans were randomly selected from a database of prostate plans that were generated by experienced planners (expert plans). The anatomical data (CT scan and delineation of organs) of these patients and the KBRT algorithm were given to a novice with no prior treatment planning experience. The inexperienced planner used the knowledge-based algorithm to predict the dose that the OARs receive based on their proximity to the treated volume. The population-based OAR constraints were changed to the predicted doses. A KBRT plan was subsequently generated. The KBRT and expert plans were compared for the achieved target coverage and OAR sparing. The target coverages were compared using the Uniformity Index (UI), while 5 dose-volume points (D₁₀, D_30, D₅₀, D₇₀ and D₉₀) were used to compare the OARs (bladder and rectum) doses. Wilcoxon matched-pairs signed rank test was used to check for significant differences (p < 0.05) between both datasets.

Results

The KBRT and expert plans achieved mean UI values of 1.10 ± 0.03 and 1.10 ± 0.04, respectively. The Wilcoxon test showed no statistically significant difference between both results. The D₉₀, D_70, D₅₀, D₃₀ and D₁₀ values of the two planning strategies, and the Wilcoxon test results suggests that the KBRT plans achieved a statistically significant lower bladder dose (at D₃₀), while the expert plans achieved a statistically significant lower rectal dose (at D₁₀ and D₃₀).

Conclusions

The results of this study show that the KBRT treatment planning approach is a promising method to objectively incorporate patient anatomical variations in radiotherapy treatment planning.

【 授权许可】

   
2015 Nwankwo et al.; licensee BioMed Central.

【 图 表 】

Fig. 1.

Fig. 2.

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