Dosimetric evaluation of variation in Library of plans selection for cervical cancer radiotherapy

IF 4.9 1区医学 Q1 ONCOLOGY Radiotherapy and Oncology Pub Date : 2025-03-05 DOI:10.1016/j.radonc.2025.110835

Yvonne J.M. de Hond, Paul M.A. van Haaren, An-Sofie E. Verrijssen, Rob H.N. Tijssen, Coen W. Hurkmans

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Abstract

Purpose

The aim was to determine whether differences in treatment plan selection methods from a Library-of-Plans (LoP) on cone-beam computed tomography (CBCT) leads to significant discrepancies in total accumulated dose.

Methods

Ten cervical cancer patients were retrospectively analyzed on plan selection and dose distribution. Dose accumulation was performed using two different plan selection methods. 1) The clinical plan selections (i.e. plans as selected during actual treatment) and 2) automatic plan selection, which was based on the largest overlap between LoP clinical target volume (CTV) and (auto-)delineated CTV on CBCT. To evaluate the influence of daily plan selection on the treatment dose, the dose of selected plans was calculated on the daily CBCTs for all fractions and accumulated on the CT. The predefined clinical goals were used to determine if there was a relevant dose difference between the clinical LoP-selection, automatic LoP-selection, and selecting solely the default plan (i.e. full bladder plan with similar margins).

Results

Different methods of LoP-plan selection did not result in significant dose differences. However, the default non-LoP plan resulted in significant dose differences compared to LoP-selection methods, with a reduced target coverage (99 % vs 100 %) and higher V40Gy to the rectum (55 % vs 44 %) compared to the clinical selection, respectively.

Conclusions

LoP is robust to variations in plan selection and LoP outperforms non-LoP approaches in terms of target coverage and organs-at-risk (OAR) sparing. Therefore, LoP is a safe and efficient alternative to online adaptive replanning, particularly for longer fractionation schemes.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.