Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Department of Radiation Oncology, Hôpital Riviera-Chablais, Avenue de la Prairie 3, CH-1800, Vevey, Switzerland.
Radiat Oncol. 2018 Sep 10;13(1):170. doi: 10.1186/s13014-018-1113-z.
Automated treatment planning and/or optimization systems (ATPS) are in the process of broad clinical implementation aiming at reducing inter-planner variability, reducing the planning time allocated for the optimization process and improving plan quality. Five different ATPS used clinically were evaluated for advanced head and neck cancer (HNC).
Three radiation oncology departments compared 5 different ATPS: 1) Automatic Interactive Optimizer (AIO) in combination with RapidArc (in-house developed and Varian Medical Systems); 2) Auto-Planning (AP) (Philips Radiation Oncology Systems); 3) RapidPlan version 13.6 (RP1) with HNC model from University Hospital A (Varian Medical Systems, Palo Alto, USA); 4) RapidPlan version 13.7 (RP2) combined with scripting for automated setup of fields with HNC model from University Hospital B; 5) Raystation multicriteria optimization algorithm version 5 (RS) (Laboratories AB, Stockholm, Sweden). Eight randomly selected HNC cases from institution A and 8 from institution B were used. PTV coverage, mean and maximum dose to the organs at risk and effective planning time were compared. Ranking was done based on 3 Gy increments for the parallel organs.
All planning systems achieved the hard dose constraints for the PTVs and serial organs for all patients. Overall, AP achieved the best ranking for the parallel organs followed by RS, AIO, RP2 and RP1. The oral cavity mean dose was the lowest for RS (31.3 ± 17.6 Gy), followed by AP (33.8 ± 17.8 Gy), RP1 (34.1 ± 16.7 Gy), AIO (36.1 ± 16.8 Gy) and RP2 (36.3 ± 16.2 Gy). The submandibular glands mean dose was 33.6 ± 10.8 Gy (AP), 35.2 ± 8.4 Gy (AIO), 35.5 ± 9.3 Gy (RP2), 36.9 ± 7.6 Gy (RS) and 38.2 ± 7.0 Gy (RP1). The average effective planning working time was substantially different between the five ATPS (in minutes): < 2 ± 1 for AIO and RP2, 5 ± 1 for AP, 15 ± 2 for RP1 and 340 ± 48 for RS, respectively.
All ATPS were able to achieve all planning DVH constraints and the effective working time was kept bellow 20 min for each ATPS except for RS. For the parallel organs, AP performed the best, although the differences were small.
自动化治疗计划和/或优化系统（ATPS）正在广泛临床实施，旨在减少计划者之间的变异性，减少优化过程分配的计划时间，并提高计划质量。评估了五个不同的 ATPS 用于治疗晚期头颈部癌症（HNC）。
三个放射肿瘤学部门比较了 5 种不同的 ATPS：1）自动交互式优化器（AIO）与 RapidArc（内部开发和瓦里安医疗系统）结合使用；2）Auto-Planning（AP）（飞利浦放射肿瘤学系统）；3）来自大学医院 A 的 HNC 模型的 RapidPlan 版本 13.6（RP1）（瓦里安医疗系统，帕洛阿尔托，美国）；4）来自大学医院 B 的 HNC 模型的 RapidPlan 版本 13.7（RP2）与脚本结合，用于自动设置字段；5）Raystation 多标准优化算法版本 5（RS）（Laboratories AB，斯德哥尔摩，瑞典）。使用机构 A 和机构 B 的 8 个随机选择的 HNC 病例。比较了 PTV 覆盖率、危及器官的平均剂量和最大剂量以及有效计划时间。基于 3 Gy 的增量对平行器官进行了排名。
所有计划系统均满足所有患者 PTV 和连续器官的硬性剂量限制。总体而言，AP 对平行器官的排名最好，其次是 RS、AIO、RP2 和 RP1。口腔平均剂量最低的是 RS（31.3±17.6 Gy），其次是 AP（33.8±17.8 Gy）、RP1（34.1±16.7 Gy）、AIO（36.1±16.8 Gy）和 RP2（36.3±16.2 Gy）。下颌下腺平均剂量为 33.6±10.8 Gy（AP）、35.2±8.4 Gy（AIO）、35.5±9.3 Gy（RP2）、36.9±7.6 Gy（RS）和 38.2±7.0 Gy（RP1）。五个 ATPS 的平均有效计划工作时间有很大差异（分钟）：<2±1 用于 AIO 和 RP2、5±1 用于 AP、15±2 用于 RP1 和 340±48 用于 RS。
所有 ATPS 都能够达到所有计划的剂量体积直方图限制，除了 RS 之外，每个 ATPS 的有效工作时间都保持在 20 分钟以下。对于平行器官，AP 表现最好，尽管差异很小。
