Dosimetric comparison between laterality-specific and general knowledge-based planning models for nonsmall cell lung...

Area of Science:

• Radiation Oncology
• Medical Physics

Background:

• Nonsmall cell lung cancer (NSCLC) radiotherapy planning requires precise dose delivery.
• RapidPlan, a knowledge-based treatment planning system, aims to improve plan quality and efficiency.
• Investigating laterality-specific models may optimize dose distribution for NSCLC.

Purpose of the Study:

• To evaluate the dosimetric impact of laterality-specific RapidPlan models compared to a general model for NSCLC radiotherapy.
• To determine if specialized models for right-sided and left-sided tumors offer significant advantages.

Main Methods:

• Three RapidPlan models (Right, Left, General) were developed and trained for lung radiotherapy.
• Validation involved 26 NSCLC cases (13 right, 13 left) optimized with each model.
• Dosimetric endpoints were analyzed using paired sample t-tests against RTOG 0617 criteria.

Main Results:

• Statistically significant differences were observed in spinal cord and esophagus doses between laterality-specific models.
• The left model yielded lower spinal cord Dmax and D0.03cc for right-sided cases.
• Despite these differences, overall plan quality showed no substantial variation between general and laterality-specific models.

Conclusions:

• While minor dosimetric variations exist, laterality-specific RapidPlan models do not offer a discernible advantage in overall plan quality for NSCLC.
• A single, general RapidPlan model appears sufficient for conventional lung radiotherapy, simplifying treatment planning.