Thompson Christopher, Pagett Christopher, Lilley John, Svensson Stina, Eriksson Kjell, Bokrantz Rasmus, Ödén Jakob, Nix Michael, Murray Louise, Appelt Ane
Leeds Cancer Centre, Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK.
RaySearch Laboratories, SE-104 30 Stockholm, Sweden.
Cancers (Basel). 2023 Jul 28;15(15):3831. doi: 10.3390/cancers15153831.
(1) Background: The STRIDeR (Support Tool for Re-Irradiation Decisions guided by Radiobiology) planning pathway aims to facilitate anatomically appropriate and radiobiologically meaningful re-irradiation (reRT). This work evaluated the STRIDeR pathway for robustness compared to a more conservative manual pathway. (2) Methods: For ten high-grade glioma reRT patient cases, uncertainties were applied and cumulative doses re-summed. Geometric uncertainties of 3, 6 and 9 mm were applied to the background dose, and LQ model robustness was tested using / variations (values 1, 2 and 5 Gy) and the linear quadratic linear (LQL) model δ variations (values 0.1 and 0.2). STRIDeR robust optimised plans, incorporating the geometric and / uncertainties during optimisation, were also generated. (3) Results: The STRIDeR and manual pathways both achieved clinically acceptable plans in 8/10 cases but with statistically significant improvements in the PTV D98% ( 0.01) for STRIDeR. Geometric and LQ robustness tests showed comparable robustness within both pathways. STRIDeR plans generated to incorporate uncertainties during optimisation resulted in a superior plan robustness with a minimal impact on PTV dose benefits. (4) Conclusions: Our results indicate that STRIDeR pathway plans achieved a similar robustness to manual pathways with improved PTV doses. Geometric and LQ model uncertainties can be incorporated into the STRIDeR pathway to facilitate robust optimisation.
(1) 背景：STRIDeR（基于放射生物学的再照射决策支持工具）规划路径旨在促进解剖学上合适且放射生物学上有意义的再照射（reRT）。这项工作评估了STRIDeR路径相对于更保守的手动路径的稳健性。(2) 方法：对于10例高级别胶质瘤再照射患者病例，应用不确定性并重新计算累积剂量。对背景剂量应用3、6和9毫米的几何不确定性，并使用/变化（值为1、2和5戈瑞）和线性二次线性（LQL）模型δ变化（值为0.1和0.2）测试LQ模型的稳健性。还生成了在优化过程中纳入几何和/不确定性的STRIDeR稳健优化计划。(3) 结果：STRIDeR和手动路径在8/10的病例中均实现了临床可接受的计划，但STRIDeR的PTV D98%有统计学显著改善（P<0.01）。几何和LQ稳健性测试表明两条路径内的稳健性相当。在优化过程中生成的纳入不确定性的STRIDeR计划产生了更好的计划稳健性，对PTV剂量益处的影响最小。(4) 结论：我们的结果表明，STRIDeR路径计划实现了与手动路径相似的稳健性，同时PTV剂量有所改善。几何和LQ模型不确定性可纳入STRIDeR路径以促进稳健优化。
