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Technical note: Optimization functions for re-irradiation treatment planning.

Jakob Ödén1, Kjell Eriksson1, Stina Svensson1

  • 1RaySeach Laboratories AB, Stockholm, Sweden.

Medical Physics
|November 3, 2023
PubMed
Summary
This summary is machine-generated.

Dedicated software for re-irradiation planning is lacking. This study introduces novel optimization functions using accumulated equivalent dose in 2-Gy fractions (EQD2) to improve treatment planning, balancing target coverage and organ at risk sparing.

Keywords:
equivalent doseoptimization functionsre-irradiation

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment Planning

Background:

  • Re-irradiation is a growing clinical practice.
  • Dedicated software for re-irradiation planning is currently unavailable.

Purpose of the Study:

  • To develop and evaluate novel dose-based optimization functions for re-irradiation planning.
  • To incorporate accumulated equivalent dose in 2-Gy fractions (EQD2) into planning algorithms.
  • To enable voxelwise adjustment of EQD2 penalization levels based on previously delivered dose (EQD2deliv).

Main Methods:

  • Standard dose-based optimization functions were adapted for re-irradiation.
  • Utilized rigid or deformable dose mapping and tissue-specific parameters (α/β, recovery coefficients).
  • Evaluated three re-planning strategies (reRTregular, reRTreduce, reRTvoxelwise) on a virtual human phantom for a fictitious prostate relapse PTV.

Main Results:

  • All strategies yielded similar dose distributions for repeated irradiation.
  • Re-irradiation scenarios showed reduced OAR EQD2 with reRTreduce and reRTvoxelwise compared to reRTregular (approx. 1-10 Gy reduction).
  • reRTreduce resulted in distorted dose distributions and hot spots, while reRTregular and reRTvoxelwise maintained PTV coverage without hot spots.

Conclusions:

  • The proposed EQD2-based optimization functions offer new possibilities for re-irradiation planning.
  • These functions allow flexible trade-offs between target coverage and OAR sparing.
  • Voxelwise adapted penalization levels based on EQD2deliv provide enhanced planning control.