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Knowledge-based plan optimization for prostate SBRT delivered with CyberKnife according to RTOG0938 protocol.

Davide Monticelli1, Roberta Castriconi2, Alessia Tudda1

  • 1Università degli Studi di Milano, Milano, Italy; Medical Physics Department, IRCCS San Raffaele Scientific Institute, Milano, Italy.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)
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Summary

This study successfully adapted knowledge-based (KB) planning for CyberKnife Stereotactic Body Radiation Therapy (SBRT) for prostate cancer, improving organ-at-risk sparing and plan quality.

Keywords:
CyberKnifeKnowledge-based planningProstate cancerSBRT

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Computational Biology

Background:

  • Stereotactic Body Radiation Therapy (SBRT) is a precise radiation technique.
  • CyberKnife is a robotic radiosurgery system.
  • Knowledge-based (KB) planning optimizes radiation treatment plans.

Purpose of the Study:

  • To extend the KB automatic planning approach to CyberKnife for prostate cancer SBRT.
  • To evaluate the performance of KB-optimized plans compared to traditional plans.

Main Methods:

  • Developed and trained a KB model using 51 CyberKnife SBRT prostate cancer plans.
  • Validated the KB model on 20 new patients using sequential optimization (SO) and VOLO algorithms.
  • Compared KB-optimized plans (KB-TP) against original treatment plans (TP) for dosimetric parameters.

Main Results:

  • KB-TP plans showed improved organ-at-risk sparing with SO and better PTV coverage with VOLO.
  • While PTV V95% was slightly worse with SO, OAR sparing significantly improved.
  • VOLO optimization demonstrated significantly better PTV coverage and improved bladder sparing at low-intermediate doses.

Conclusions:

  • Successfully developed and validated an extended KB optimization approach for CyberKnife SBRT in prostate cancer.
  • The KB approach offers significant improvements in plan quality and organ-at-risk sparing.