RapidPlan for Knowledge-Based Planning of Malignant Pleural Mesothelioma

Area of Science:

• Radiation Oncology
• Medical Physics
• Oncology

Background:

• Malignant pleural mesothelioma treatment planning is complex due to large target volumes and proximity to critical organs.
• Sparing overlapping or adjacent organs at risk is crucial for minimizing treatment toxicity.

Purpose of the Study:

• To develop and validate a knowledge-based treatment planning model using RapidPlan (RP) for patients with malignant pleural mesothelioma and two intact lungs.
• To assess the impact of RP on organ sparing, treatment planning time, and potential for dose escalation.

Main Methods:

• A dose estimation model was trained using volumetric modulated arc therapy (VMAT) data from 57 patients.
• The RP model was validated on 23 new patients, comparing RP plans against manually created clinical plans.
• Treatment planning times for RP and clinical plans were compared.

Main Results:

• RP significantly improved sparing for the contralateral lung, heart, stomach, esophagus, and ipsilateral kidney compared to clinical plans.
• Significant reductions were observed in contralateral lung V5 Gy (13.9%) and V10 Gy (7.9%), and mean heart dose (5 Gy).
• RP reduced planning time to approximately 21 minutes from over 4 hours, enabling a potential increase in prescription dose by one fraction.

Conclusions:

• The RapidPlan knowledge-based model offers superior critical organ sparing for malignant pleural mesothelioma.
• RP significantly reduces treatment planning time, enhancing efficiency for radiation oncology departments.
• This approach facilitates potentially higher radiation doses, improving treatment outcomes for malignant pleural mesothelioma.