Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance.

Tol, Jim P;Dahele, Max;Grégoire, Vincent;Overgaard, Jens;Verbakel, Wilko F A R;et.al.
(2019) Radiotherapy & Oncology — Vol. 130, p. 75-81 (2019)

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Authors
  • Tol, Jim P
    Author
  • Dahele, Max
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  • Grégoire, VincentUCLouvain
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  • Overgaard, Jens
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  • Verbakel, Wilko F A R
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Abstract
INTRODUCTION: Radiotherapy treatment plan quality can influence clinical trial outcomes and general QA may not identify suboptimal organ-at-risk (OAR) sparing. We retrospectively performed patient-specific quality assurance (QA) of 100 head-and-neck cancer (HNC) plans from the EORTC-1219-DAHANCA-29 study. MATERIALS AND METHODS: A 177-patient RapidPlan (Varian Medical Systems) model comprising institutional HNC plans was used to QA trial plans (Ptrial). RapidPlan plans (Prapidplan) were created using RapidPlan and Eclipse scripting to achieve a high degree of automation. Comparison between Prapidplan mean predicted/achieved OAR doses, and Ptrial mean OAR doses was made for parotid/submandibular glands (PGs/SMGs) and swallowing muscles (SM). RESULTS: OAR predictions were made within 2 min per patient. Averaged PG/SMG/SM mean doses were 2.0/9.0/3.8 Gy lower in Prapidplan. Using predicted Prapidplan combined mean OAR dose as the benchmark, a total of 60/27/4 trial plans could be improved by 3/6/9 Gy respectively. DISCUSSION: Individualized QA indicated that OAR sparing could frequently be improved in EORTC-1219 study plans, even though they met the trial's generic plan criteria. Automated, patient-specific QA can be performed within a few minutes and should be considered to reduce the influence of planning variation on trial outcomes.
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Tol, J. P., Dahele, M., Grégoire, V., Overgaard, J., Slotman, B. J., & Verbakel, W. F. A. R. (2019). Analysis of EORTC-1219-DAHANCA-29 trial plans demonstrates the potential of knowledge-based planning to provide patient-specific treatment plan quality assurance. Radiotherapy & Oncology, 130, 75-81. https://doi.org/10.1016/j.radonc.2018.10.005 (Original work published 2019)