Using a knowledge-based planning solution to select patients for proton therapy. Issue 2 (August 2017)

• Record Type: Journal Article
• Authors: Delaney, Alexander R.; Dahele, Max; Tol, Jim P.; Kuijper, Ingrid T.; Slotman, Ben J.; Verbakel, Wilko F.A.R.
• Is Part Of: Radiotherapy and oncology. Volume 124:Issue 2(2017:Aug.)
• Page Start: 263
• Page End: 270
• Publication Date: 2017-08
• Subjects: Proton therapy -- Knowledge-based planning -- Patient selection -- Head and neck cancer; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.03.020
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Background and purpose: Patient selection for proton therapy by comparing proton/photon treatment plans is time-consuming and prone to bias. RapidPlan™, a knowledge-based-planning solution, uses plan-libraries to model and predict organ-at-risk (OAR) dose-volume-histograms (DVHs). We investigated whether RapidPlan, utilizing an algorithm based only on photon beam characteristics, could generate proton DVH-predictions and whether these could correctly identify patients for proton therapy. Material and methods: ModelPROT and ModelPHOT comprised 30 head-and-neck cancer proton and photon plans, respectively. Proton and photon knowledge-based-plans (KBPs) were made for ten evaluation-patients. DVH-prediction accuracy was analyzed by comparing predicted-vs-achieved mean OAR doses. KBPs and manual plans were compared using salivary gland and swallowing muscle mean doses. For illustration, patients were selected for protons if predicted ModelPHOT mean dose minus predicted ModelPROT mean dose (ΔPrediction) for combined OARs was ≥6 Gy, and benchmarked using achieved KBP doses. Results: Achieved and predicted ModelPROT /ModelPHOT mean dose R 2 was 0.95/0.98. Generally, achieved mean dose for ModelPHOT /ModelPROT KBPs was respectively lower/higher than predicted. Comparing ModelPROT /ModelPHOT KBPs with manual plans, salivary and swallowing mean doses increased/decreased by <2 Gy, on average. ΔPrediction ≥ 6 Gy correctly selected 4 of 5 patients for protons. Conclusions: Knowledge-based DVH-predictions can provide efficient, patient-specific selection for protons. A proton-specific RapidPlan-solution could improve results.