TY - JOUR
T1 - Development of a multicentre automated model to reduce planning variability in radiotherapy of prostate cancer
AU - Panettieri, Vanessa
AU - Ball, David
AU - Chapman, Adam
AU - Cristofaro, Nigel
AU - Gawthrop, Janet
AU - Griffin, Peter
AU - Herath, Sisira
AU - Hoyle, Susan
AU - Jukes, Liam
AU - Kron, Tomas
AU - Markham, Cathy
AU - Marr, Loretta
AU - Moloney, Phillip
AU - Nelli, Flavio
AU - Ramachandran, Prabhakar
AU - Smith, Amanda
AU - Hornby, Colin J.
N1 - Funding Information:
The authors would like to acknowledge the Department of Health and Human Services of the State of Victoria, Australia, for the support provided in this project.
Publisher Copyright:
© 2019 The Authors
PY - 2019/7
Y1 - 2019/7
N2 - Background and purpose: Inter-institutional studies highlighted correlation between consistent radiotherapy quality and improved overall patient survival. In treatment planning automation has the potential to address differences due to user-experience and training, promoting standardisation. The aim of this study was to evaluate implementation and clinical effect of a multicentre collaboratively-developed automated planning model for Intensity-Modulated Radiation Therapy/Volumetric-Modulated Arc Therapy of prostate. The model was built using a variety of public institutions’ clinical plans, incorporating different contouring and dose protocols, aiming at minimising their variation. Methods and materials: A model using 110 clinically approved and treated prostate plans provided by different radiotherapy centres was built with RapidPlan (RP), for use on intact and post-prostatectomy prostate cases. The model was validated, distributed and introduced into clinical practice in all institutions. To investigate its impact a total of 126 patients, originally manually inverse planned (OP), were replanned using RP without additional planner manual intervention. Target and organ-at-risk (OAR) metrics were statistically compared between original and automated plans. Results: For all centres combined and individually, RP provided plans comparable or superior to OP for all dose metrics. Statistically significant reductions with RP were found in bladder (V40Gy) and rectal (V50Gy) low doses (within 2.3% and 3.4% for combined and 4% and 10% individually). No clinically significant changes were seen for the PTV, independently of seminal vesicle inclusion. Conclusion: This project showed it is feasible to develop, share and implement RP models created with plans from different institutions treated with a variety of techniques and dose protocols, with the potential of improving treatment planning results and/or efficiency despite the original variability.
AB - Background and purpose: Inter-institutional studies highlighted correlation between consistent radiotherapy quality and improved overall patient survival. In treatment planning automation has the potential to address differences due to user-experience and training, promoting standardisation. The aim of this study was to evaluate implementation and clinical effect of a multicentre collaboratively-developed automated planning model for Intensity-Modulated Radiation Therapy/Volumetric-Modulated Arc Therapy of prostate. The model was built using a variety of public institutions’ clinical plans, incorporating different contouring and dose protocols, aiming at minimising their variation. Methods and materials: A model using 110 clinically approved and treated prostate plans provided by different radiotherapy centres was built with RapidPlan (RP), for use on intact and post-prostatectomy prostate cases. The model was validated, distributed and introduced into clinical practice in all institutions. To investigate its impact a total of 126 patients, originally manually inverse planned (OP), were replanned using RP without additional planner manual intervention. Target and organ-at-risk (OAR) metrics were statistically compared between original and automated plans. Results: For all centres combined and individually, RP provided plans comparable or superior to OP for all dose metrics. Statistically significant reductions with RP were found in bladder (V40Gy) and rectal (V50Gy) low doses (within 2.3% and 3.4% for combined and 4% and 10% individually). No clinically significant changes were seen for the PTV, independently of seminal vesicle inclusion. Conclusion: This project showed it is feasible to develop, share and implement RP models created with plans from different institutions treated with a variety of techniques and dose protocols, with the potential of improving treatment planning results and/or efficiency despite the original variability.
UR - http://www.scopus.com/inward/record.url?scp=85070240466&partnerID=8YFLogxK
U2 - 10.1016/j.phro.2019.07.005
DO - 10.1016/j.phro.2019.07.005
M3 - Article
C2 - 33458275
AN - SCOPUS:85070240466
SN - 2405-6316
VL - 11
SP - 34
EP - 40
JO - Physics and Imaging in Radiation Oncology
JF - Physics and Imaging in Radiation Oncology
ER -
