A feasibility study of automated inverse treatment planning for cancer of the prostate Journal Article
| Authors: | Reinstein, L. E.; Wang, X. H.; Burman, C. M.; Chen, Z.; Mohan, R.; Kutcher, G.; Leibel, S. A.; Fuks, Z. |
| Article Title: | A feasibility study of automated inverse treatment planning for cancer of the prostate |
| Abstract: | Purpose: The development of automated 'inverse planning,' utilizing intensity-modulated radiation therapy (IMRT) raises the question of whether this new technique can provide a practical and efficient means of dose escalation in conformal treatment of cancer of the prostate. The purpose of this feasibility study was to determine a single set of inverse-planning parameters that can be used for a variety of different prostate patient geometries to automatically generate escalated dose (≤81 Gy) IMRT plans that satisfy normal tissue constraints for rectal and bladder walls. Methods: We studied a subset of the 46 patients who were previously treated at Memorial Sloan Kettering Cancer Center (MSKCC) to a total dose of 81 Gy using a 3D conformal approach. Six patients were selected for our study and replanned using an analytical reverse-planning algorithm (referred to as OPT3D) applied to 8 intensity modulated, co-axial radiation beams. A set of more than a dozen inverse planning parameters were adjusted by trial and error until the resulting dose distributions satisfied the critical organ dose-volume constraints imposed by our study rules (D30 ≤ 75.6 Gy and D10 ≤ 80 Gy for the rectal wall; D15 ≤ 80 Gy for the bladder wall) for the sample of patients selected. The OPT3D-generated plans were compared to hand-generated BEV plans using cumulative DVH analysis. Results: A single set of inverse- planning parameters was found that was able to automatically generate IMRT plans meeting all critical organ dose-volume constraints for all but one of the patients in our study. [The exception failed to meet bladder dose constraints for both IMRT and BEV methods, due to extensive overlap between the planning target volume (PTV) and bladder contours]. Based upon analysis of the cumulative dose-volume histogram (DVH) for the prostate PTV, the D95 (DX is defined such that x% of the volume receives a dose ≤ DX), averaged over all patients, was approximately 81 Gy. The average D90 and mean dose values were 85 Gy and 93 Gy, respectively. Although a similar D95 was achieved using the BEV-generated plans, the D90 and mean dose values were substantially higher for the inverse planning (OPT3D) method. Conclusion: This limited 'paper study' shows IMRT with inverse planning to be a promising technique for the treatment of prostate cancer to high doses. We determined a small set of inverse-planning parameter values that was able to automatically design intensity-modulated radiotherapy (IMRT) plans for a subset of 6 patients previously treated at MSKCC to 81 Gy using BEV planning techniques. With one minor exception, the resulting plans succeeded in meeting predetermined dose-volume constraints while at the same time allowing an increase in the mean dose and D90 to the prostate PTV. These 8 field plans also resulted in reduced dosage to the femoral heads. This automated technique is efficient in terms of planning effort and, with proper software for computer-controlled MLC, may be appropriate for clinical use. The clinical feasibility of this approach for a larger group of patients is currently under study. |
| Keywords: | clinical article; treatment planning; cancer radiotherapy; radiation dose; radiotherapy dosage; automation; prostate cancer; prostatic neoplasms; feasibility study; imrt; feasibility studies; urinary bladder; intensity modulation; radiotherapy planning, computer-assisted; optimization; conformal radiotherapy; humans; human; male; priority journal; article; inverse treatment planning; 3d rtp |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 40 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1998-01-01 |
| Start Page: | 207 |
| End Page: | 214 |
| Language: | English |
| DOI: | 10.1016/s0360-3016(97)00582-8 |
| PUBMED: | 9422578 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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