Planning Automation for Treatment Techniques Comparison and Robustness Analysis: Tangential Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy for Whole Breast Irradiation

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2025-03-01 DOI:10.1016/j.adro.2025.101719

Livia Marrazzo MSc , Deborah Chilà MSc , Immacolata Vanore MSc , Roberto Pellegrini MSc , Peter Voet PhD , Vanessa Di Cataldo MD , Icro Meattini MD , Margherita Zani MSc , Chiara Arilli MSc , Silvia Calusi PhD , Marta Casati MSc , Antonella Compagnucci MSc , Cinzia Talamonti PhD , Lorenzo Livi MD , Stefania Pallotta MSc

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引用次数: 0

Abstract

Purpose

This study evaluates the use of the mCycle automated planning system integrated into the Monaco Treatment Planning System for step-and-shoot intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in whole breast irradiation (WBI). The aim was to assess whether automation can standardize plan quality across a diverse patient cohort and compare dosimetric outcomes and robustness of the 2 techniques against setup errors and anatomical variations.

Methods and Materials

A total of 65 patients with breast cancer who underwent postoperative WBI were selected for the study. Treatment plans were generated using mCycle, which employs multicriteria optimization with no manual intervention. Two automated planning techniques—IMRT and VMAT—were implemented and evaluated based on dosimetric outcomes, physician review, planning time, and plan robustness. The plan deliverability was verified through γ index and point dose measurements.

Results

The mCycle system produced clinically acceptable plans for both IMRT and VMAT across all patient cohorts. VMAT showed superior target coverage (V95% = 97.9%) and better sparing of ipsilateral organs at risks (OARs), whereas IMRT demonstrated enhanced sparing of contralateral OARs and greater robustness to anatomical changes such as breast swelling. Planning times were reduced with VMAT because of complete automation. Plan deliverability was confirmed with high γ passing rates and acceptable point dose deviations.

Conclusions

The use of mCycle in WBI planning successfully standardized plan quality and improved workflow efficiency. VMAT provided superior target coverage and ipsilateral OAR sparing but was more sensitive to anatomical changes. IMRT showed better contralateral OAR sparing and robustness. Both techniques are viable, with advantages depending on clinical scenarios.

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计划自动化治疗技术比较和稳健性分析：切向强度调制放射治疗和体积调制弧线治疗全乳房照射

目的：本研究评估将mCycle自动计划系统集成到Monaco治疗计划系统中，用于全乳放疗（WBI）中步进射调强放射治疗（IMRT）和体积调弧治疗（VMAT）。目的是评估自动化是否可以在不同的患者队列中标准化计划质量，并比较剂量学结果和两种技术对设置错误和解剖变异的稳健性。方法和材料共选择65例乳腺癌术后WBI患者进行研究。使用mCycle生成治疗方案，该方法采用多标准优化，无需人工干预。两种自动计划技术- imrt和vmat -被实施并基于剂量学结果、医生审查、计划时间和计划稳健性进行评估。通过γ指数和点剂量测量验证了方案的可交付性。结果mCycle系统在所有患者队列中为IMRT和VMAT制定了临床可接受的计划。VMAT显示了更好的靶覆盖（V95% = 97.9%）和更好地保留同侧危险器官（OARs），而IMRT显示了增强的对侧OARs的保留和对解剖变化（如乳房肿胀）更强的稳健性。由于完全自动化，VMAT减少了计划时间。高γ通过率和可接受的点剂量偏差证实了计划的可交付性。结论mCycle在WBI计划中的应用成功地规范了计划质量，提高了工作流程效率。VMAT提供了更好的靶覆盖和同侧桨叶保留，但对解剖变化更敏感。IMRT显示更好的对侧桨叶保留和稳健性。这两种技术都是可行的，其优势取决于临床情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.