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Updated: Jul 19, 2025

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The STRIDeR tool improves re-irradiation planning for glioma patients, offering better target doses with comparable robustness to manual methods. It effectively incorporates uncertainties for optimized treatment.

Keywords:
equivalent dosere-irradiationrobustnesstreatment plan optimisation

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Planning

Background:

  • Re-irradiation (reRT) requires precise planning for efficacy and safety.
  • The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) pathway was developed to enhance reRT planning.
  • Evaluating STRIDeR's robustness against a manual pathway is crucial for clinical adoption.

Purpose of the Study:

  • To compare the robustness of the STRIDeR planning pathway against a conventional manual pathway for re-irradiation.
  • To assess the impact of geometric and radiobiological uncertainties on treatment plans.
  • To determine if STRIDeR can facilitate robustly optimized reRT plans.

Main Methods:

  • Ten high-grade glioma reRT cases were analyzed.
  • Geometric uncertainties (3-9 mm) and radiobiological variations (α/β, δ) were applied.
  • STRIDeR plans incorporating uncertainties during optimization were generated and compared to manual plans.

Main Results:

  • Both STRIDeR and manual pathways yielded clinically acceptable plans in 8/10 cases.
  • STRIDeR demonstrated statistically significant improvements in PTV D98% (p < 0.01).
  • STRIDeR plans incorporating uncertainties showed superior robustness with minimal impact on target dose benefits.

Conclusions:

  • STRIDeR pathway plans offer comparable robustness to manual pathways with enhanced PTV doses.
  • The STRIDeR tool can integrate geometric and radiobiological uncertainties for robust optimization.
  • STRIDeR facilitates anatomically appropriate and radiobiologically meaningful re-irradiation planning.