Knowledge-based radiation therapy KBRT treatment planning versus planning by experts: validation of a KBRT algorithm for prostate cancer treatment planningReportar como inadecuado

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Radiation Oncology

, 10:111

First Online: 10 May 2015Received: 20 April 2015Accepted: 30 April 2015DOI: 10.1186-s13014-015-0416-6

Cite this article as: Nwankwo, O., Mekdash, H., Sihono, D.S.K. et al. Radiat Oncol 2015 10: 111. doi:10.1186-s13014-015-0416-6


BackgroundA knowledge-based radiation therapy KBRT treatment planning algorithm was recently developed. The purpose of this work is to investigate how plans that are generated with the objective KBRT approach compare to those that rely on the judgment of the experienced planner.

MethodsThirty volumetric modulated arc therapy plans were randomly selected from a database of prostate plans that were generated by experienced planners expert plans. The anatomical data CT scan and delineation of organs of these patients and the KBRT algorithm were given to a novice with no prior treatment planning experience. The inexperienced planner used the knowledge-based algorithm to predict the dose that the OARs receive based on their proximity to the treated volume. The population-based OAR constraints were changed to the predicted doses. A KBRT plan was subsequently generated. The KBRT and expert plans were compared for the achieved target coverage and OAR sparing. The target coverages were compared using the Uniformity Index UI, while 5 dose-volume points D10, D30, D50, D70 and D90 were used to compare the OARs bladder and rectum doses. Wilcoxon matched-pairs signed rank test was used to check for significant differences p < 0.05 between both datasets.

ResultsThe KBRT and expert plans achieved mean UI values of 1.10 ± 0.03 and 1.10 ± 0.04, respectively. The Wilcoxon test showed no statistically significant difference between both results. The D90, D70, D50, D30 and D10 values of the two planning strategies, and the Wilcoxon test results suggests that the KBRT plans achieved a statistically significant lower bladder dose at D30, while the expert plans achieved a statistically significant lower rectal dose at D10 and D30.

ConclusionsThe results of this study show that the KBRT treatment planning approach is a promising method to objectively incorporate patient anatomical variations in radiotherapy treatment planning.

KeywordsKnowledge-based radiation therapy KBRT treatment planning Personalized radiotherapy treatment planning Dose prediction algorithm Treatment plan optimization Normal tissue sparing AbbreviationsKBRTKnowledge-based radiation therapy treatment planning

OAROrgan at risk

UIUniformity index

PTVPlanning target volume

VMATVolumetric modulated arc therapy

CTComputed tomography

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Autor: Obioma Nwankwo - Hana Mekdash - Dwi Seno Kuncoro Sihono - Frederik Wenz - Gerhard Glatting


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