Knowledge-Based Planning and Multi-criteria Optimization Combination with Volumetric Modulated Arc Therapy for...

Area of Science:

• Radiation Oncology
• Medical Physics
• Cancer Treatment

Background:

• Volumetric Modulated Arc Therapy (VMAT) is a common technique for laryngeal cancer.
• Optimizing treatment plans is crucial for maximizing tumor coverage while minimizing dose to organs at risk.

Purpose of the Study:

• To evaluate the effectiveness of knowledge-based planning (KBP) combined with multi-criteria optimization (MCO) for laryngeal VMAT.
• To compare KBP + MCO with manual planning (MP) and standard KBP in terms of plan quality and organ-at-risk sparing.

Main Methods:

• A KBP model was trained using previously treated VMAT plans.
• Manual plans (MP) were created for 10 patients.
• KBP plans were generated without planner intervention during optimization.
• An additional MCO step was applied to KBP plans (KBP + MCO).
• Plans were evaluated based on planning target volume (PTV) coverage (D95%), conformity index (CI), and dose to the carotid arteries and spinal cord.

Main Results:

• KBP + MCO achieved higher average PTV D95% (94.1%) compared to MP (90.2%) and KBP (92.8%).
• KBP + MCO demonstrated improved dose sparing for the carotid arteries at lower dose levels (V10-30 Gy) compared to MP.
• No significant differences were observed in PTV coverage, CI95%, or maximum spinal cord dose among the three planning methods.

Conclusions:

• Knowledge-based planning with multi-criteria optimization (KBP + MCO) enhances carotid artery dose sparing in laryngeal VMAT.
• This approach effectively maintains planning target volume coverage.
• KBP + MCO represents a promising strategy for improving the quality and safety of laryngeal VMAT.