Evaluation of a Knowledge-Based Planning Solution for Head and Neck Cancer
Evaluation of a Knowledge-Based Planning Solution for Head and Neck Cancer
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DOI：
10.1016/j.ijrobp.2014.11.014
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发表时间：
2015-03-01
影响因子：
7
通讯作者：
Verbakel, Wilko F. A. R.
中科院分区：
文献类型：
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作者：
Tol, Jim P.;Delaney, Alexander R.;Verbakel, Wilko F. A. R.
目的：自动化和基于知识的规划技术旨在减少规划质量的差异。RapidPlan使用由不同患者计划组成的库来建立一个模型，该模型可以预测新患者的可实现剂量-体积直方图(DVH)，并使用这些模型来设置优化目标。方法和材料：60例近期头颈癌患者的容量调节弧形治疗方案，包括保留唾液腺、吞咽肌肉和口腔，被平均分成两个模型，模型(30A)和模型(30B)，并合并到第三个模型(模型(60))。为两个评估组制定了基于知识的计划：评估组1(EG1)，由15名新近患者组成；评估组2(EG2)，由15名老年患者组成，其中只保留唾液腺。使用HIB/HIE=100x(D2%-D98%)/D50%，以及复合唾液腺、吞咽肌肉和口腔的平均剂量(分别为D-SAL、D-SWAL和D-oc)，将RapidPlan的结果与临床计划(CP)的增强和/或选择性计划目标体积均匀度指数进行比较。结果：对于EG1，RapidPlan的HIB和HIE值分别比CP提高1.0%~1.3%和1.0%~0.6%。模型(30A)、模型(30B)和模型(60)的Dsal和Dswal值相似，分别平均减少0.1、1.0和0.8GY和4.8、3.7和4.4GY。然而，不同的危险器官之间存在差异，模型(30B)与CP、模型(30A)和模型(60)相比，D-oc分别增加了0.1、3.2和2.8Gy.当患者被标记为异常值时，计划质量不太一致。对于EG2，RapidPlan平均减少了4.1~4.9GyDal，而HIB和HIE分别减少了1.1%到1.5%和2.3%到1.9%。结论：如果患者的桨计划目标体积几何在模型中包含的范围内，基于快速计划的治疗计划可以与CP相媲美。EG2结果显示，仅保留唾液腺的患者可以应用包括吞咽肌肉和口腔保留的模型。这可能会允许各研究所之间共享模型库。对不充分的计划和模型库人口的最佳检测需要进一步调查。(C)2015年爱思唯尔公司。
Purpose: Automated and knowledge-based planning techniques aim to reduce variations in plan quality. RapidPlan uses a library consisting of different patient plans to make a model that can predict achievable dose-volume histograms (DVHs) for new patients and uses those models for setting optimization objectives. We bench-marked RapidPlan versus clinical plans for 2 patient groups, using 3 different libraries.Methods and Materials: Volumetric modulated arc therapy plans of 60 recent head and neck cancer patients that included sparing of the salivary glands, swallowing muscles, and oral cavity were evenly divided between 2 models, Model(30A) and Model(30B), and were combined in a third model, Model(60). Knowledge-based plans were created for 2 evaluation groups: evaluation group 1 (EG1), consisting of 15 recent patients, and evaluation group 2 (EG2), consisting of 15 older patients in whom only the salivary glands were spared. RapidPlan results were compared with clinical plans (CP) for boost and/or elective planning target volume homogeneity index, using HIB/HIE = 100 x (D2% - D98%)/D50%, and mean dose to composite salivary glands, swallowing muscles, and oral cavity (D-sal, D-swal, and D-oc, respectively).Results: For EG1, RapidPlan improved HIB and HIE values compared with CP by 1.0% to 1.3% and 1.0% to 0.6%, respectively. Comparable Dsal and Dswal values were seen in Model(30A), Model(30B), and Model(60), decreasing by an average of 0.1, 1.0, and 0.8 Gy and 4.8, 3.7, and 4.4 Gy, respectively. However, differences were noted between individual organs at risk (OARs), with Model(30B) increasing D-oc by 0.1, 3.2, and 2.8 Gy compared with CP, Model(30A), and Model(60). Plan quality was less consistent when the patient was flagged as an outlier. For EG2, RapidPlan decreased D-sal by 4.1 to 4.9 Gy on average, whereas HIB and HIE decreased by 1.1% to 1.5% and 2.3% to 1.9%, respectively.Conclusions: RapidPlan knowledge-based treatment plans were comparable to CP if the patient's OAR-planning target volume geometry was within the range of those included in the models. EG2 results showed that a model including swallowing-muscle and oral-cavity sparing can be applied to patients with only salivary gland sparing. This may allow model library sharing between institutes. Optimal detection of inadequate plans and population of model libraries requires further investigation. (C) 2015 Elsevier Inc.