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Advanced optimization methods for whole pelvic and local prostate external beam therapy
Martin Buschmann1, Yvette Seppenwoolde1, Tilo Wiezorek2
1Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/AKH Wien, Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria.
Multicriteria optimization (MCO) for prostate VMAT planning offers comparable plan quality to standard methods with reduced planning time. While manual VMAT slightly improved organ-at-risk sparing in whole pelvic treatments, MCO demonstrated efficiency for prostate cancer radiotherapy.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cancer Treatment Planning
Background:
- Radiation treatment planning involves balancing multiple, often conflicting, objectives.
- Multicriteria optimization (MCO) is a promising approach for addressing these complex planning challenges.
Purpose of the Study:
- To investigate a multicriteria optimization (MCO) algorithm for volumetric modulated arc therapy (VMAT) planning in prostate cancer.
- To compare the VMAT-MCO technique against standard inverse VMAT (sVMAT) and Tomotherapy planning.
Main Methods:
- A two-stage VMAT plan was generated for ten prostate cancer patients.
- Stage 1 delivered 22Gy to the prostate; Stage 2 delivered 50.4Gy to lymph nodes and 56Gy to the prostate with a simultaneous integrated boost.
- Plans were compared for quality and planning time efficiency across VMAT-MCO, sVMAT, and Tomotherapy.
Main Results:
- Plan quality was similar across all techniques.
- sVMAT showed superior rectum and bowel sparing compared to VMAT-MCO in whole pelvic treatments.
- Tomotherapy resulted in higher bladder dose in stage 1 and lower rectal dose in stage 2 compared to VMAT-MCO.
- MCO reduced planning time by up to 12 minutes for stage 1 and 38 minutes for stage 2 plans.
Conclusions:
- MCO effectively generates conformal prostate VMAT plans with minimal workload for prostate-only and prostate plus lymph node treatments.
- Manual VMAT optimization provided slightly better organ-at-risk sparing in whole pelvic plans compared to VMAT-MCO.
- For primary prostate treatment, VMAT-MCO achieved equal plan quality to manual optimization.
