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Structure and template assisted multi-dose-level inverse planning (STAMP) for interstitial GYN brachytherapy
Shiqin Su1, Claire Zhang2, Choonik Lee2
1Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX.
Purpose:
To introduce STAMP (structure- and template-assisted multi-dose-level planning), a standardized semi-automatic inverse planning workflow for multi-dose-level interstitial gynecologic (GYN) HDR brachytherapy using the VEGO (Varian, v16.1) optimization algorithm. The workflow aims to enhance planning consistency and reduce reliance on planner expertise.
Materials And Methods:
STAMP uses predefined optimization structures and standardized objective templates to guide inverse planning. This approach was retrospectively applied to 30 GYN interstitial HDR brachytherapy patients at a single institution. Plan quality was evaluated using total OAR D2cc, CTV coverage, and total dwell times, and compared against clinical plans using two-sided Wilcoxon rank-sum tests (p = 0.05).
Results:
STAMP plans required a median of 4 optimization iterations (range: 1-8). Clinical and STAMP plans achieved comparable CTV coverages, and both met EMBRACE I OAR constraints, with STAMP showing slightly improved OAR sparing. No statistically significant differences were found in dosimetric metrics or total dwell times.
Conclusions:
We developed a semi-automatic clinical workflow for multi-dose-level inverse planning for interstitial GYN HDR brachytherapy, utilizing optimization structures and objective templates. Our study demonstrated the ability to efficiently generate noninferior inverse plans using this standardized workflow with reduced variability.
