Interactive decision-support tool for risk-based radiation therapy plan comparison for Hodgkin lymphoma

Area of Science:

• Radiation oncology
• Medical physics
• Clinical decision support

Background:

• Radiation therapy (RT) planning for Hodgkin lymphoma (HL) requires balancing tumor control with normal tissue toxicity.
• Comparing different RT plans involves complex trade-offs between various normal tissue endpoints.
• Current methods may not adequately quantify the risks associated with specific treatment plans.

Purpose of the Study:

• To introduce a novel decision-support tool for quantitative risk estimation and visualization of normal tissue endpoints in HL RT planning.
• To facilitate objective comparison of different RT treatment plans.
• To aid radiation oncologists in clinical decision-making during RT planning.

Main Methods:

• Development of a decision-support tool integrating dose-response data from the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) and newer literature.
• Application of "relevance scores" to assess the applicability of input data to current HL RT.
• Visualization of dose-response relationships and endpoint trade-offs.

Main Results:

• The tool was applied to reoptimize a volumetric modulated arc therapy (VMAT) plan for an HL patient with head-and-neck involvement, visualizing dose-response curve steepness.
• Quantitative evaluation and visualization of the trade-off between 3D conformal RT and VMAT plans for a mediastinal HL patient were performed.

Conclusions:

• The developed tool provides quantitative risk estimates for multiple normal tissue endpoints.
• This decision-support system supplements radiation oncologists' clinical judgment when evaluating RT options.
• The tool enhances the comparison of different RT treatment strategies for Hodgkin lymphoma.