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Benchmarking daily adaptation using fully automated radiotherapy treatment plan optimization for rectal cancer
Thyrza Z Jagt1, Tomas M Janssen1, Anja Betgen1
1Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Physics and Imaging in Radiation Oncology
|September 12, 2022
Summary
Daily adaptation of radiotherapy plans for rectal cancer can maintain treatment quality without altering planning objectives. This automated approach ensures robust and high-quality adaptations throughout the course of therapy.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cancer Treatment
Background:
- Daily plan adaptation in radiotherapy adjusts treatment plans before delivery.
- A common method involves re-optimizing reference plan objectives directly.
- The quality of daily adaptation without objective tweaking requires verification.
Purpose of the Study:
- To verify if daily radiotherapy plan adaptation without objective tweaking can maintain plan quality.
- To evaluate the robustness of daily adaptation techniques.
- To benchmark daily adaptation using automated treatment planning.
Main Methods:
- Fifteen rectal cancer patients were included.
- Automated treatment planning generated reference plans.
- Daily adapted plans re-optimized reference objectives without tweaking for 74 fraction scans.
- Adapted plans were compared to autoplanning plans.
Main Results:
- Differences in PTV D2% and D98% between autoplanning and adapted plans were within 0.7 Gy.
- Mean differences for PTV doses were within 0.3 Gy.
- Dose differences for organs at risk (Bowel+Bladder, Lumbar Skin) were within 2.6 Gy.
Conclusions:
- Automated treatment planning serves as a benchmark for daily adaptation methods.
- The investigated adaptation workflow robustly achieves high-quality adaptations.
- Patient-specific planning objectives do not require daily adjustment for rectal cancer radiotherapy.
