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Helical tomotherapy to LINAC plan conversion utilizing RayStation Fallback planning.

Xin Zhang¹, Jose Penagaricano¹, Ganesh Narayanasamy¹

¹Radiation Oncology Department, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA.

Journal of Applied Clinical Medical Physics

|March 15, 2017

Summary

Fallback (FB) plans generated by RayStation for helical tomotherapy (HT) treatments on Varian TrueBeam linear accelerators were evaluated. Most FB-IMRT and FB-3D plans were clinically acceptable, offering comparable or improved organ at risk sparing.

Keywords:

Fallback treatment planning RayStation dosimetric comparison helical tomotherapy

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Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Planning

Background:

The need for reliable backup radiotherapy plans is crucial for uninterrupted patient treatment.
RayStation's Fallback (FB) planning module aims to generate equivalent backup plans for alternative linear accelerators.
Helical tomotherapy (HT) is a complex radiotherapy technique requiring robust fallback strategies.

Purpose of the Study:

To evaluate the dosimetric quality and clinical acceptability of RayStation FB plans generated for Varian TrueBeam linear accelerators.
To compare FB plans (Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy) against original HT plans for lung, head and neck, and prostate cancer patients.
To assess the organ at risk (OAR) sparing capabilities of FB plans.

Main Methods:

FB plans (FB-IMRT and FB-3D) were generated using the RayStation FB module for 30 patients previously treated with HT.
Dosimetric parameters including PTV coverage (R95), PTV mean dose (Dmean), conformity index (CI), and homogeneity index (HI) were evaluated.
Comparison was made between original HT plans and generated FB plans on the TrueBeam linear accelerator.

Main Results:

FB-IMRT plans showed statistical comparability to HT plans, with minor degradations in PTV HI (prostate) and PTV R95/HI (HN multitarget).
FB-3D plans for lung cancer demonstrated comparable PTV R95 but worse Dmean, CI, and HI than HT plans.
FB plans generally provided superior OAR sparing compared to HT plans, with most FB-IMRT and 90% of FB-3D plans being clinically acceptable without optimization.

Conclusions:

RayStation FB plans are largely clinically acceptable and can provide comparable or improved OAR sparing for backup radiotherapy.
While statistical differences exist, they may not always be clinically significant, highlighting the utility of FB planning.
FB-3D plans may require more optimization than FB-IMRT plans to fully simulate original treatment plans.