Quality assessment for VMAT prostate radiotherapy planning based on data envelopment analysis.

Area of Science:

• Medical Physics
• Radiation Oncology
• Health Services Research

Background:

• Radiotherapy treatment planning is often inefficient due to iterative trial-and-error methods.
• This inefficiency can lead to suboptimal plan quality and acceptance of non-ideal plans.

Purpose of the Study:

• To introduce a Data Envelopment Analysis (DEA) based quality assessment method for radiotherapy plans.
• To address the inefficiency in treatment planning and ensure plans achieve the best attainable quality.

Main Methods:

• Applied DEA to 37 prostate cancer treatment plans.
• Used rectal generalized equivalent uniform dose (gEUD) as input and planning target volume (PTV) D95 as output.
• Incorporated rectum-PTV overlap percentage as a non-discretionary output to account for anatomical variations.

Main Results:

• DEA identified five plans with potential for improvement.
• Re-optimization of these five plans led to an average 1.84 Gy reduction in rectal gEUD.
• This improvement was achieved with a minimal average reduction of 0.07 Gy in PTV D95, demonstrating preserved target coverage.

Conclusions:

• DEA effectively identifies radiotherapy plans with room for quality improvement.
• The method assists planners in making informed decisions, ensuring plan acceptance only when quality is near optimal.
• DEA facilitates better organ-at-risk sparing without compromising target dose coverage.