Knowledge-Based RapidPlan Volumetric Modulated Arc Therapy Model in Nasopharyngeal Carcinoma

RapidPlan^TM (RP) Eclipse^@, a commercial knowledge-based planning software, predicts radiation doses, enhancing treatment planning efficiency and quality. This study developed a nasopharyngeal carcinoma (NPC) volumetric modulated arc therapy RP model and assessed its quality and efficiency against manual plans.

The existing plans for 160 patients with NPC constituted the RP model training cohort. An additional 33 patients formed a testing cohort to compare RP and manual plans based on dose-volume histograms, isodose curves, physician plan scores, and selection.

The RP plan could be completed within 1 hour. RP plans demonstrated superior conformity compared with manual plans in planning target volume 70. RP plans outperformed manual plans in reducing organs-at-risks (OARs) doses. For advanced T3/4 tumors, chiasma and optic nerve doses remained similar to manual plans. RP plans had higher physician-rated scores in dose-volume histograms of targets, OARs, isodose curves, and holistic scores. Clinical plan acceptance rates of RP plans reached 100%. Physicians chose RP plans over manual plans for 31, 30, and 28 patients for doctors A, B, and C, mainly because of superior OAR sparing and higher conformity.

The RP plan efficiently generates high-quality NPC volumetric modulated arc therapy plans. Further applications of RP Eclipse in single-institutional clinical flows and multi-institutional collaborations or clinical trials are warranted.