Standardization of volumetric modulated arc therapy-based frameless stereotactic technique using a multidimensional...

Area of Science:

• Medical Physics
• Radiation Oncology
• Computational Biology

Background:

• Stereotactic radiosurgery (SRS) and radiotherapy (SRT) require precise treatment planning.
• Volumetric Modulated Arc Therapy (VMAT) is an advanced radiation delivery technique.
• Knowledge-Based Planning (KBP) aims to improve efficiency and consistency in treatment planning.

Purpose of the Study:

• To introduce a novel KBP methodology for VMAT in SRS and SRT.
• To utilize an ensemble mapping technique within a Monte Carlo planning system.
• To evaluate the effectiveness of KBP compared to independent planning.

Main Methods:

• Assembled patient libraries based on eight distinct parameters.
• Selected appropriate library plans for new patients using categorization.
• Generated KBP plans and compared them with independently generated plans (IP).
• Evaluated PTV coverage, dose conformity, and planning time.

Main Results:

• KBP plans demonstrated a marginally lower dosimetric quality than IP but met clinical requirements.
• A significant reduction in planning time was observed for KBP (111.0 ± 84.1 min) compared to IP (248.2 ± 96.6 min).
• The ensemble mapping technique accurately identified suitable library plans, particularly for organ-at-risk challenged cases.

Conclusions:

• The developed KBP methodology is effective for VMAT in SRS/SRT using Monte Carlo planning.
• KBP significantly reduces planning time and is less dependent on planner expertise.
• KBP plans achieve acceptable clinical outcomes and dose constraints.