Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL, 60153 USA.
Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardine Cancer Center, Loyola University Chicago, Maywood, IL, 60153 USA.
Med Dosim. 2022;47(1):8-13. doi: 10.1016/j.meddos.2021.06.004. Epub 2021 Sep 1.
The goal of this study is to fully automate the treatment planning and delivery process of hippocampal-sparing whole brain irradiation (HS-WBRT) by combining a RapidPlan (RP) knowledge-based planning model and HyperArc (HA) technology. Additionally, this study compares the dosimetric performance of RapidPlan-HyperArc (RP-HA) treatment plans with RP plans and volumetric modulated arc therapy (VMAT) plans. Ten patients previously treated with HS-WBRT using conventional VMAT were re-planned using RP-HA technique and RP model for HS-WBRT. Treatment plans were generated for 30Gy in 3Gy fractions using 6MV photon beam on a TrueBeam linear accelerator (Varian Medical Systems, Palo Alto, CA) equipped with high definition multileaf collimator (HDMLC). Target coverage, homogeneity index (HI), Paddick Conformity index (CI), dose to organs-at-risk (OARs) provided by the 3 planning modalities were compared, and a paired t-test was performed. Total number of monitor units (MU), effective planning time and beam-on-time time were reported and evaluated for each plan. RP-HA plans achieved on average a 4% increase in D of PTV, a 26% improvement in HI, a 2.3% increase in CI, when compared to RP plans. Furthermore, RP-HA plans provided on average 11% decrease in D of hippocampi when compared to VMAT plans. All RP-HA plans were generated in less than 30 minutes while RP plans took 40 minutes and VMAT plans required on average 9 hours to complete. Regarding beam-on-time time, it was estimated that RP-HA plans take on average 5 minutes to deliver while RP and VMAT plans require 6.5 and 10 minutes, respectively. RP-HA method provides fully automated planning and delivery for HS-WBRT. The auto-generated plans together with automated treatment delivery allow standardization of plan quality, increased efficiency and ultimately improved patient care.
这项研究的目的是通过结合 RapidPlan（RP）基于知识的规划模型和 HyperArc（HA）技术，实现海马保护全脑放疗（HS-WBRT）的治疗计划和实施过程的完全自动化。此外，本研究比较了 RapidPlan-HyperArc（RP-HA）治疗计划与 RP 计划和容积调强弧形治疗（VMAT）计划的剂量学性能。10 例先前采用常规 VMAT 进行 HS-WBRT 治疗的患者，使用 RP-HA 技术和 RP 模型对 HS-WBRT 进行重新规划。使用配备高清多叶准直器（HDMLC）的 TrueBeam 直线加速器（Varian Medical Systems，Palo Alto，CA），以 6MV 光子束对 30Gy/3Gy 分次进行治疗计划生成。比较了 3 种规划模式提供的靶区覆盖率、均匀性指数（HI）、Paddick 适形指数（CI）、危及器官（OARs）剂量，并进行了配对 t 检验。报告并评估了每个计划的总监测单位（MU）、有效计划时间和射束开启时间。与 RP 计划相比，RP-HA 计划平均使 PTV 的 D 增加 4%，HI 改善 26%，CI 增加 2.3%。此外，与 VMAT 计划相比，RP-HA 计划平均使海马 D 减少 11%。所有 RP-HA 计划均在 30 分钟内生成，而 RP 计划耗时 40 分钟，VMAT 计划平均需要 9 小时才能完成。关于射束开启时间，估计 RP-HA 计划平均需要 5 分钟即可完成，而 RP 和 VMAT 计划分别需要 6.5 分钟和 10 分钟。RP-HA 方法为 HS-WBRT 提供了完全自动化的规划和实施。自动生成的计划和自动化的治疗实施允许规范计划质量，提高效率，最终改善患者护理。
