Maree Stefanus C, Luong Ngoc Hoang, Kooreman Ernst S, van Wieringen Niek, Bel Arjan, Hinnen Karel A, Westerveld Henrike, Pieters Bradley R, Bosman Peter A N, Alderliesten Tanja
Department of Radiation Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Life Sciences and Health Research Group, Centrum Wiskunde & Informatica, Amsterdam, The Netherlands.
Brachytherapy. 2019 May-Jun;18(3):396-403. doi: 10.1016/j.brachy.2018.12.010. Epub 2019 Feb 2.
Bi-objective treatment planning for high-dose-rate prostate brachytherapy is a novel treatment planning method with two separate objectives that represent target coverage and organ-at-risk sparing. In this study, we investigated the feasibility and plan quality of this method by means of a retrospective observer study.
Current planning sessions were recorded to configure a bi-objective optimization model and to assess its applicability to our clinical practice. Optimization software, GOMEA, was then used to automatically generate a large set of plans with different trade-offs in the two objectives for each of 18 patients treated with high-dose-rate prostate brachytherapy. From this set, five plans per patient were selected for comparison to the clinical plan in terms of satisfaction of planning criteria and in a retrospective observer study. Three brachytherapists were asked to evaluate the blinded plans and select the preferred one.
Recordings demonstrated applicability of the bi-objective optimization model to our clinical practice. For 14/18 patients, GOMEA plans satisfied all planning criteria, compared with 4/18 clinical plans. In the observer study, in 53/54 cases, a GOMEA plan was preferred over the clinical plan. When asked for consensus among observers, this ratio was 17/18 patients. Observers highly appreciated the insight gained from comparing multiple plans with different trade-offs simultaneously.
The bi-objective optimization model adapted well to our clinical practice. GOMEA plans were considered equal or superior to the clinical plans. In addition, presenting multiple high-quality plans provided novel insight into patient-specific trade-offs.
高剂量率前列腺近距离放射治疗的双目标治疗计划是一种新颖的治疗计划方法，具有两个分别代表靶区覆盖和危及器官保护的独立目标。在本研究中，我们通过一项回顾性观察研究来探究该方法的可行性和计划质量。
记录当前的计划制定过程，以构建双目标优化模型并评估其在我们临床实践中的适用性。然后使用优化软件GOMEA，为18例接受高剂量率前列腺近距离放射治疗的患者中的每一位自动生成大量在两个目标上具有不同权衡的计划。从该计划集中，为每位患者选择五个计划，以便在计划标准的满意度方面以及在一项回顾性观察研究中与临床计划进行比较。邀请三位近距离放射治疗师评估这些盲法计划并选择首选计划。
记录表明双目标优化模型适用于我们的临床实践。对于14/18的患者，GOMEA计划满足所有计划标准，而临床计划为4/18。在观察研究中，在53/54的病例中，GOMEA计划比临床计划更受青睐。当询问观察者之间的共识时，这一比例为17/18患者。观察者高度赞赏通过同时比较具有不同权衡的多个计划所获得的见解。
双目标优化模型很好地适应了我们的临床实践。GOMEA计划被认为与临床计划相当或更优。此外，呈现多个高质量计划为特定患者的权衡提供了新的见解。
