Automated Robust Proton Planning Using Dose-Volume Histogram-Based Mimicking of the Photon Reference Dose and Reducing Organ at Risk Dose Optimization

International Journal of Radiation Oncology, Biology, Physics
Roel G J KierkelsErik W Korevaar

Abstract

Patient selection for proton therapy is increasingly based on proton to photon plan comparisons. To improve efficient decision making, we developed a dose mimicking and reducing (DMR) algorithm to automatically generate a robust proton plan from a reference photon dose, as well as target and organ at risk (OAR) delineations. The DMR algorithm was evaluated in 40 patients with head and neck cancer. The first step of the DMR algorithm comprises dose-volume histogram-based mimicking of the photon dose distribution in the clinical target volumes and OARs. Target robustness is included by mimicking the nominal photon dose in 21 perturbed scenarios. The second step of the optimization aims to reduce the OAR doses while retaining the robust target coverage as achieved in the first step. We evaluated each DMR plan against the manually robustly optimized reference proton plan in terms of plan robustness (voxel-wise minimum dose). Furthermore, the DMR plans were evaluated against the reference photon plan using normal tissue complication probability (NTCP) models of xerostomia, dysphagia, and tube feeding dependence. Consequently, ΔNTCPs were defined as the difference between the NTCPs of the photon and proton plans. The dose distributio...Continue Reading

Citations

Jul 30, 2019·The British Journal of Radiology·Hakan NystromPetra Witt Nystrom
Aug 20, 2019·Journal of the National Cancer Institute. Monographs·Siri Beier JensenMary E Reyland
Aug 10, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Makbule TambasJohannes A Langendijk
Sep 9, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Dirk WagenaarStefan Both
Nov 24, 2020·Physics in Medicine and Biology·Harald PaganettiTony Lomax
Mar 6, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Jasper KouwenbergBen Heijmen
Apr 24, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Makbule TambasJohannes A Langendijk
Aug 15, 2021·Computer Methods and Programs in Biomedicine·Long WeiHaijiao Shang

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