期刊
RADIOTHERAPY AND ONCOLOGY
卷 130, 期 -, 页码 75-81出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2018.10.005
关键词
Treatment planning; Quality assurance; Clinical trials; Head and neck cancer
Introduction: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. Materials and methods: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (P-trial). RapidPlan plans (P-rapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between P-rapidplan mean predicted/achieved OAR doses, and P-trial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). Results: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in P-rapidplan. Using predicted P-rapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. Discussion: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes. (C) 2018 Elsevier B.V. All rights reserved.
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