Michelle Oud , Sebastiaan Breedveld , Marta Giżyńska , Yi Hsuan Chen , Steven Habraken , Zoltán Perkó , Ben Heijmen , Mischa Hoogeman
{"title":"自适应 IMPT 的剂量学优势与增加工作量和治疗时间的对比--需要自动化。","authors":"Michelle Oud , Sebastiaan Breedveld , Marta Giżyńska , Yi Hsuan Chen , Steven Habraken , Zoltán Perkó , Ben Heijmen , Mischa Hoogeman","doi":"10.1016/j.radonc.2024.110548","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>In head-and-neck IMPT, trigger-based offline plan adaptation (Offline<sub>trigger-based</sub>) is often used. Our goal was to compare this to four alternative adaptive strategies for dosimetry, workload and treatment time, considering also foreseen further technological advancements, including anticipated automation.</div></div><div><h3>Materials and methods</h3><div>Alternative strategies included weekly offline re-planning (Offline<sub>weekly</sub>), daily plan selection from a library (Library<sub>static</sub> and Library<sub>progsressive</sub>) and a fast, approximate daily online re-optimization approach (Online<sub>re-opt</sub>). Impact on CTV coverage and NTCPs was assessed by simulations based on repeat-CTs from 15 patients. Full daily re-planning was used as dosimetric benchmark. Increases in workload and treatment time were estimated.</div></div><div><h3>Results</h3><div>Both for coverage and NTCPs, fast Online<sub>re-opt</sub> performed as well as full re-planning. Compared to current practice, Online<strong><sub>re</sub></strong><sub>-opt</sub> showed enhanced probabilities for high coverage, and resulted in reductions in grade ≥ II NTCPs of 4.6 ± 1.7 %-point for xerostomia and 4.2 ± 2.3 %-point for dysphagia. Offline<sub>weekly</sub> and library strategies did not show coverage enhancements and resulted in smaller NTCP improvements. Further automation can largely limit workload and treatment time increases. With anticipated further automation, adaptation-related workload of Offline<sub>weekly</sub>, Library<sub>static</sub>, Library<sub>progressive</sub>, and Online<sub>re-opt</sub> was expected to increase by 3, 8, 21, and 66 h for 35 fraction treatment courses compared to Offline<sub>trigger-based</sub>. The corresponding adaptation-related prolonged treatment times were estimated to be 0, 4, 6, and 29 min/fraction.</div></div><div><h3>Conclusion</h3><div>Online adaptive strategies could approach dosimetric quality of full re-planning at the cost of additional workload and prolonged treatment time compared to the current offline adaptive strategy. Automation needs to play a key role in making more complex adaptive approaches feasible.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"201 ","pages":"Article 110548"},"PeriodicalIF":4.9000,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dosimetric advantages of adaptive IMPT vs. Enhanced workload and treatment time – A need for automation\",\"authors\":\"Michelle Oud , Sebastiaan Breedveld , Marta Giżyńska , Yi Hsuan Chen , Steven Habraken , Zoltán Perkó , Ben Heijmen , Mischa Hoogeman\",\"doi\":\"10.1016/j.radonc.2024.110548\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>In head-and-neck IMPT, trigger-based offline plan adaptation (Offline<sub>trigger-based</sub>) is often used. Our goal was to compare this to four alternative adaptive strategies for dosimetry, workload and treatment time, considering also foreseen further technological advancements, including anticipated automation.</div></div><div><h3>Materials and methods</h3><div>Alternative strategies included weekly offline re-planning (Offline<sub>weekly</sub>), daily plan selection from a library (Library<sub>static</sub> and Library<sub>progsressive</sub>) and a fast, approximate daily online re-optimization approach (Online<sub>re-opt</sub>). Impact on CTV coverage and NTCPs was assessed by simulations based on repeat-CTs from 15 patients. Full daily re-planning was used as dosimetric benchmark. Increases in workload and treatment time were estimated.</div></div><div><h3>Results</h3><div>Both for coverage and NTCPs, fast Online<sub>re-opt</sub> performed as well as full re-planning. Compared to current practice, Online<strong><sub>re</sub></strong><sub>-opt</sub> showed enhanced probabilities for high coverage, and resulted in reductions in grade ≥ II NTCPs of 4.6 ± 1.7 %-point for xerostomia and 4.2 ± 2.3 %-point for dysphagia. Offline<sub>weekly</sub> and library strategies did not show coverage enhancements and resulted in smaller NTCP improvements. Further automation can largely limit workload and treatment time increases. With anticipated further automation, adaptation-related workload of Offline<sub>weekly</sub>, Library<sub>static</sub>, Library<sub>progressive</sub>, and Online<sub>re-opt</sub> was expected to increase by 3, 8, 21, and 66 h for 35 fraction treatment courses compared to Offline<sub>trigger-based</sub>. The corresponding adaptation-related prolonged treatment times were estimated to be 0, 4, 6, and 29 min/fraction.</div></div><div><h3>Conclusion</h3><div>Online adaptive strategies could approach dosimetric quality of full re-planning at the cost of additional workload and prolonged treatment time compared to the current offline adaptive strategy. Automation needs to play a key role in making more complex adaptive approaches feasible.</div></div>\",\"PeriodicalId\":21041,\"journal\":{\"name\":\"Radiotherapy and Oncology\",\"volume\":\"201 \",\"pages\":\"Article 110548\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-09-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiotherapy and Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167814024035266\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167814024035266","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Dosimetric advantages of adaptive IMPT vs. Enhanced workload and treatment time – A need for automation
Introduction
In head-and-neck IMPT, trigger-based offline plan adaptation (Offlinetrigger-based) is often used. Our goal was to compare this to four alternative adaptive strategies for dosimetry, workload and treatment time, considering also foreseen further technological advancements, including anticipated automation.
Materials and methods
Alternative strategies included weekly offline re-planning (Offlineweekly), daily plan selection from a library (Librarystatic and Libraryprogsressive) and a fast, approximate daily online re-optimization approach (Onlinere-opt). Impact on CTV coverage and NTCPs was assessed by simulations based on repeat-CTs from 15 patients. Full daily re-planning was used as dosimetric benchmark. Increases in workload and treatment time were estimated.
Results
Both for coverage and NTCPs, fast Onlinere-opt performed as well as full re-planning. Compared to current practice, Onlinere-opt showed enhanced probabilities for high coverage, and resulted in reductions in grade ≥ II NTCPs of 4.6 ± 1.7 %-point for xerostomia and 4.2 ± 2.3 %-point for dysphagia. Offlineweekly and library strategies did not show coverage enhancements and resulted in smaller NTCP improvements. Further automation can largely limit workload and treatment time increases. With anticipated further automation, adaptation-related workload of Offlineweekly, Librarystatic, Libraryprogressive, and Onlinere-opt was expected to increase by 3, 8, 21, and 66 h for 35 fraction treatment courses compared to Offlinetrigger-based. The corresponding adaptation-related prolonged treatment times were estimated to be 0, 4, 6, and 29 min/fraction.
Conclusion
Online adaptive strategies could approach dosimetric quality of full re-planning at the cost of additional workload and prolonged treatment time compared to the current offline adaptive strategy. Automation needs to play a key role in making more complex adaptive approaches feasible.
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.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
