To investigate whether an overlap volume histogram (OVH)-driven planning application using an intensity-modulated radiation therapy(IMRT)database can guide and automate volumetric-modulated arc therapy (VMAT) planning for head-and-neck cancer.
Based on comparable head-and-neck dosimetric results between planner-generated VMAT and IMRT plans, an inhouse developed, OVH-driven automated planning application containing a database of prior clinical head-and-neck IMRT plans is built into Pinnacle3 SmartArc for VMAT planning. Double-arc VMAT plans of four oropharynx, four nasopharynx, and four larynx patients are generated and compared with corresponding clinical IMRT plans.
Each VMAT plan is automatically generated in two optimization rounds, while the average number of optimization rounds in generating a clinical IMRT plan is 43. In VMAT plans, statistical superiority (p < 0.01) in sparing of the cord+4 mm, brainstem, brachial plexus, larynx, and inner ear is observed with a slight degradation in low-dose-level planning target volume (PTV) coverage. On average, D0.1 cc to the cord+4 mm, brainstem and brachial plexus is reduced by 3.7, 4.9, and 1.6 Gy, respectively; V(50 Gy) to the larynx is reduced by 5.3%; mean dose to the inner ear is reduced by 4.4 Gy; V95 of low-dose-level PTV coverage is reduced by 0.3% with p = 0.25.
IMRT-data-driven VMAT planning offers a potential method for generating VMAT plans that are comparable to IMRT plans in terms of dosimetric quality.
Received 04 October 2012Revised 03 January 2013Accepted 07 January 2013Published online 24 January 2013
Article outline: I. INTRODUCTION II. METHODS AND MATERIALS II.A. A geometry-driven planning methodology II.B. Focus of the study II.C. An automated VMAT planning application II.D. C-IMRT database II.E. D-VMAT plans II.F. Dosimetric comparison II.G. Efficiency comparison III. RESULTS III.A. Primary OAR sparing III.B. PTV coverage III.C. Secondary OAR sparing III.D. Planning efficiency III.E. An example for an oropharynx patient IV. DISCUSSION V. CONCLUSION
Giuseppe Sanguineti and
Source:Med. Phys. 40, 021714 (
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