Optimal timing of re-planning for head and neck adaptive radiotherapy.
Radiother Oncol
; 194: 110145, 2024 05.
Article
en En
| MEDLINE
| ID: mdl-38341093
ABSTRACT
BACKGROUND AND PURPOSE:
Adaptive radiotherapy (ART) relies on re-planning to correct treatment variations, but the optimal timing of re-planning to account for dose changes in head and neck organs at risk (OARs) is still under investigation. We aimed to find out the optimal timing of re-planning in head and neck ART. MATERIALS ANDMETHODS:
A total of 110 head and neck cancer patients were retrospectively enrolled. A semi auto-segmentation method was applied to obtain the weekly mean dose (Dmean) to OARs. The K-nearest-neighbour method was used for missing data imputation of weekly Dmean. A dose deviation map was built using the planning Dmean and weekly Dmean values and then used to simulate different ART scenarios consisting of 1 to 6 re-plannings. The difference between accumulated Dmean and planning Dmean before re-planning (ΔDmean_acc_noART) and after re-planning (ΔDmean_acc_ART) were evaluated and compared.RESULTS:
Among all the OARs, supraglottic showed the largest ΔDmean_acc_noART (1.23 ± 3.13 Gy) and most cases of ΔDmean_acc_noART > 3 Gy (26 patients). The 3rd week is suggested in the optimal timing of re-planning for 10 OARs. For all the organs except arytenoid, 2 re-plannings were able to guarantee the ΔDmean_acc_ART below 3 Gy while the average |ΔDmean_acc_ART| was below 1 Gy. ART scenarios of 2_4, 3_4, 3_5 (week of re-planning separated with "_") were able to guarantee ΔDmean_acc_ART of 99 % of patients below 3 Gy simultaneously for 19 OARs.CONCLUSIONS:
The optimal timing of re-planning was suggested for different organs at risk in head and neck adaptive radiotherapy. Generic scenarios of timing and frequency for re-planning can be applied to guarantee the increase of accumulated mean dose within 3 Gy simultaneously for multiple organs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dosificación Radioterapéutica
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Planificación de la Radioterapia Asistida por Computador
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Órganos en Riesgo
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Neoplasias de Cabeza y Cuello
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Radiother Oncol
Año:
2024
Tipo del documento:
Article