The role of a knowledge based dose-volume histogram predictive model in the optimisation of intensity-modulated proton plans for hepatocellular carcinoma patients : Training and validation of a novel commercial system.
Strahlenther Onkol
; 197(4): 332-342, 2021 Apr.
Article
en En
| MEDLINE
| ID: mdl-32676685
ABSTRACT
PURPOSE:
To investigate the performance of a knowledge-based RapidPlan, for optimisation of intensity-modulated proton therapy (IMPT) plans applied to hepatocellular cancer (HCC) patients.METHODS:
A cohort of 65 patients was retrospectively selected 50 were used to "train" the model, while the remaining 15 provided independent validation. The performance of the RapidPlan model was benchmarked against manual optimisation and was also compared to volumetric modulated arc therapy (RapidArc) photon plans. A subanalysis appraised the performance of the RapidPlan model applied to patients with lesions ≤300â¯cm3 or larger. Quantitative assessment was based on several metrics derived from the constraints of the NRG-GI003 clinical trial.RESULTS:
There was an equivalence between manual plans and RapidPlan-optimised IMPT plans, which outperformed the RapidArc plans. The planning dose-volume objectives were met on average for all structures except for D0.5â¯cm3 ≤30â¯Gy in the bowels. Limiting the results to the class-solution proton plans (all values in Gy), the data for manual plans vs RapidPlan-based IMPT plans, respectively, showed the following D99% to the target of 47.5⯱ 1.4 vs 47.2⯱ 1.2; for organs at risk, the mean dose to the healthy liver was 6.7⯱ 3.6 vs 6.7⯱ 3.7; the mean dose to the kidneys was 0.2⯱ 0.5 vs 0.1⯱ 0.2; D0.5â¯cm3 for the bowels was 33.4⯱ 16.4 vs 30.2⯱ 16.0; for the stomach was 17.9⯱ 19.9 vs 14.9⯱ 18.8; for the oesophagus was 17.9⯱ 15.1 vs 14.9⯱ 13.9; for the spinal cord was 0.5⯱ 1.6 vs 0.2⯱ 0.7. The model performed similarly for cases with small or large lesions.CONCLUSION:
A knowledge-based RapidPlan model was trained and validated for IMPT. The results demonstrate that RapidPlan can be trained adequately for IMPT in HCC. The quality of the RapidPlan-based plans is at least equivalent compared to what is achievable with manual planning. RapidPlan also confirmed the potential to optimise the quality of the proton therapy results, thus reducing the impact of operator planning skills on patient results.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Strahlenther Onkol
Asunto de la revista:
NEOPLASIAS
/
RADIOTERAPIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Italia