Purpose: To extend the knowledge-based (KB) automatic planning approach to CyberKnife in the case of Ste-reotactic Body Radiation Therapy (SBRT) for prostate cancer.Methods: Seventy-two clinical plans of patients treated according to the RTOG0938 protocol (36.25 Gy/5fr) with CyberKnife were exported from the CyberKnife system to Eclipse to train a KB-model using the Rapid Plan tool. The KB approach provided dose-volume objectives for specific OARs only and not PTV. Bladder, rectum and femoral heads were considered in the model. The KB-model was successfully trained on 51 plans and then validated on 20 new patients. A KB-based template was tuned in the Precision system for both sequential optimization (SO) and VOLO optimization algorithms. Plans of the validation group were re-optimized (KB-TP) using both algorithms without any operator intervention and compared against the original plans (TP) in terms of OARs/PTV dose-volume parameters. Paired Wilcoxon signed-rank tests were performed to assess statistically significant differences (p < 0.05). Results: Regarding SO, automatic KB-TP plans were generally better than or equivalent to TP plans. PTVs V95% was slightly worse while OARs sparing for KB-TP was significantly improved. Regarding VOLO optimization, the PTVs coverage was significantly better for KB-TP while there was a limited worsening in the rectum. A significant improvement was observed in the bladder in the range of low-intermediate doses.Conclusions: An extension of the KB optimization approach to the CyberKnife system has been successfully developed and validated in the case of SBRT prostate cancer.
Knowledge-based plan optimization for prostate SBRT delivered with CyberKnife according to RTOG0938 protocol / Monticelli, Davide; Castriconi, Roberta; Tudda, Alessia; Fodor, Andrei; Deantoni, Chiara; Gisella Di Muzio, Nadia; Mangili, Paola; del Vecchio, Antonella; Fiorino, Claudio; Broggi, Sara. - In: PHYSICA MEDICA. - ISSN 1120-1797. - 110:(2023). [10.1016/j.ejmp.2023.102606]
Knowledge-based plan optimization for prostate SBRT delivered with CyberKnife according to RTOG0938 protocol
Gisella Di Muzio, Nadia;
2023-01-01
Abstract
Purpose: To extend the knowledge-based (KB) automatic planning approach to CyberKnife in the case of Ste-reotactic Body Radiation Therapy (SBRT) for prostate cancer.Methods: Seventy-two clinical plans of patients treated according to the RTOG0938 protocol (36.25 Gy/5fr) with CyberKnife were exported from the CyberKnife system to Eclipse to train a KB-model using the Rapid Plan tool. The KB approach provided dose-volume objectives for specific OARs only and not PTV. Bladder, rectum and femoral heads were considered in the model. The KB-model was successfully trained on 51 plans and then validated on 20 new patients. A KB-based template was tuned in the Precision system for both sequential optimization (SO) and VOLO optimization algorithms. Plans of the validation group were re-optimized (KB-TP) using both algorithms without any operator intervention and compared against the original plans (TP) in terms of OARs/PTV dose-volume parameters. Paired Wilcoxon signed-rank tests were performed to assess statistically significant differences (p < 0.05). Results: Regarding SO, automatic KB-TP plans were generally better than or equivalent to TP plans. PTVs V95% was slightly worse while OARs sparing for KB-TP was significantly improved. Regarding VOLO optimization, the PTVs coverage was significantly better for KB-TP while there was a limited worsening in the rectum. A significant improvement was observed in the bladder in the range of low-intermediate doses.Conclusions: An extension of the KB optimization approach to the CyberKnife system has been successfully developed and validated in the case of SBRT prostate cancer.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
