Advanced optimization methods for whole pelvic and local prostate external beam therapy |
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| Institution: | 1. Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Wien, Vienna, Austria;2. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria;3. Department of Radiation Oncology, University Hospital Jena, Jena, Germany;1. Département de radio-oncologie, CHU de Québec–Université Laval, Québec, Québec, Canada;2. Centre de recherche du CHU de Québec, Québec, Québec, Canada;3. Centre de recherche sur le cancer de l’Université Laval, Québec, Québec, Canada;4. Département de d''imagerie médicale, CHU de Québec–Université Laval, Québec, Québec, Canada;5. Département de physique, de génie physique et d''optique, Université Laval, Québec, Québec, Canada;1. Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida;2. Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California;1. Ghent University Hospital, Department of Radiation Oncology and Experimental Cancer Research, Belgium;2. Ghent University Hospital, Department of Radiology, Belgium;3. Ghent University Hospital, Department of Urology, Belgium;1. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands;2. Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands;3. Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands |
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| Abstract: | PurposeRadiation treatment planning inherently involves multiple conflicting planning goals, which makes it a suitable application for multicriteria optimization (MCO). This study investigates a MCO algorithm for VMAT planning (VMAT–MCO) for prostate cancer treatments including pelvic lymph nodes and uses standard inverse VMAT optimization (sVMAT) and Tomotherapy planning as benchmarks.MethodsFor each of ten prostate cancer patients, a two stage plan was generated, consisting of a stage 1 plan delivering 22 Gy to the prostate, and a stage 2 plan delivering 50.4 Gy to the lymph nodes and 56 Gy to the prostate with a simultaneous integrated boost. The single plans were generated by three planning techniques (VMAT–MCO, sVMAT, Tomotherapy) and subsequently compared with respect to plan quality and planning time efficiency.ResultsPlan quality was similar for all techniques, but sVMAT showed slightly better rectum (on average Dmean ?7%) and bowel sparing (Dmean ?17%) compared to VMAT–MCO in the whole pelvic treatments. Tomotherapy plans exhibited higher bladder dose (Dmean +42%) in stage 1 and lower rectum dose (Dmean ?6%) in stage 2 than VMAT–MCO. Compared to manual planning, the planning time with MCO was reduced up to 12 and 38 min for stage 1 and 2 plans, respectively.ConclusionMCO can generate highly conformal prostate VMAT plans with minimal workload in the settings of prostate-only treatments and prostate plus lymph nodes irradiation. In the whole pelvic plan manual VMAT optimization led to slightly improved OAR sparing over VMAT–MCO, whereas for the primary prostate treatment plan quality was equal. |
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| Keywords: | Multicriteria optimization Whole-pelvic prostate radiotherapy VMAT Tomotherapy |
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