Direct use of multivariable normal tissue complication probability models in treatment plan optimisation for individualised head and neck cancer radiotherapy produces clinically acceptable treatment plans.
Radiother Oncol
; 112(3): 430-6, 2014 Sep.
Article
em En
| MEDLINE
| ID: mdl-25220369
ABSTRACT
BACKGROUND AND PURPOSE:
Recently, clinically validated multivariable normal tissue complication probability models (NTCP) for head and neck cancer (HNC) patients have become available. We test the feasibility of using multivariable NTCP-models directly in the optimiser for inverse treatment planning of radiotherapy to improve the dose distributions and corresponding NTCP-estimates in HNC patients. MATERIAL ANDMETHODS:
For 10 HNC cases, intensity-modulated radiotherapy plans were optimised either using objective functions based on the 'generalised equivalent uniform dose' (OFgEUD) or based on multivariable NTCP-models (OFNTCP). NTCP-models for patient-rated xerostomia, physician-rated RTOG grade II-IV dysphagia, and various patient-rated aspects of swallowing dysfunction were incorporated. The NTCP-models included dose-volume parameters as well as clinical factors contributing to a personalised optimisation process. Both optimisation techniques were compared by means of 'pseudo Pareto fronts' (target dose conformity vs. the sum of the NTCPs).RESULTS:
Both optimisation techniques resulted in clinically realistic treatment plans with only small differences. For nine patients the sum-NTCP was lower for the OFNTCP optimised plans (on average 5.7% (95%CI 1.7-9.9%, p<0.006)). Furthermore, the OFNTCP provided the advantages of fewer unknown optimisation parameters and an intrinsic mechanism of individualisation.CONCLUSIONS:
Treatment plan optimisation using multivariable NTCP-models directly in the OF is feasible as has been demonstrated for HNC radiotherapy.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Planejamento da Radioterapia Assistida por Computador
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Neoplasias de Cabeça e Pescoço
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Modelos Teóricos
Tipo de estudo:
Prognostic_studies
Limite:
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
Ano de publicação:
2014
Tipo de documento:
Article