Dosimetric evaluation of variation in Library of plans selection for cervical cancer radiotherapy

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-03-05 DOI:10.1016/j.radonc.2025.110835

Yvonne J.M. de Hond, Paul M.A. van Haaren, An-Sofie E. Verrijssen, Rob H.N. Tijssen, Coen W. Hurkmans

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Abstract

Purpose

The aim was to determine whether differences in treatment plan selection methods from a Library-of-Plans (LoP) on cone-beam computed tomography (CBCT) leads to significant discrepancies in total accumulated dose.

Methods

Ten cervical cancer patients were retrospectively analyzed on plan selection and dose distribution. Dose accumulation was performed using two different plan selection methods. 1) The clinical plan selections (i.e. plans as selected during actual treatment) and 2) automatic plan selection, which was based on the largest overlap between LoP clinical target volume (CTV) and (auto-)delineated CTV on CBCT. To evaluate the influence of daily plan selection on the treatment dose, the dose of selected plans was calculated on the daily CBCTs for all fractions and accumulated on the CT. The predefined clinical goals were used to determine if there was a relevant dose difference between the clinical LoP-selection, automatic LoP-selection, and selecting solely the default plan (i.e. full bladder plan with similar margins).

Results

Different methods of LoP-plan selection did not result in significant dose differences. However, the default non-LoP plan resulted in significant dose differences compared to LoP-selection methods, with a reduced target coverage (99 % vs 100 %) and higher V40Gy to the rectum (55 % vs 44 %) compared to the clinical selection, respectively.

Conclusions

LoP is robust to variations in plan selection and LoP outperforms non-LoP approaches in terms of target coverage and organs-at-risk (OAR) sparing. Therefore, LoP is a safe and efficient alternative to online adaptive replanning, particularly for longer fractionation schemes.

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宫颈癌放疗方案库选择变化的剂量学评价

目的探讨锥束计算机断层扫描（CBCT）方案库（LoP）中治疗方案选择方法的差异是否会导致总累积剂量的显著差异。方法回顾性分析10例宫颈癌患者的治疗方案选择和剂量分布情况。剂量累积采用两种不同的方案选择方法。1)临床方案选择（即实际治疗时选择的方案）和2)自动方案选择，即基于LoP临床靶体积（CTV）与CBCT上（自动）划定的CTV重叠最大。为了评估每日计划选择对治疗剂量的影响，将所选计划的剂量计算在所有分数的每日cbct上，并在CT上累积。使用预定义的临床目标来确定临床lop选择、自动lop选择和单独选择默认计划（即具有相似边缘的全膀胱计划）之间是否存在相关剂量差异。结果不同的LoP-plan选择方法对剂量无显著影响。然而，与lop选择方法相比，默认的非lop计划导致了显著的剂量差异，与临床选择相比，目标覆盖率降低（99%对100%），直肠V40Gy更高（55%对44%）。结论LoP对计划选择的变化具有鲁棒性，在目标覆盖和风险器官（OAR）保留方面优于非LoP方法。因此，LoP是在线自适应重新规划的一种安全有效的替代方案，特别是对于较长的分馏方案。

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

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.