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A class solution for volumetric-modulated arc therapy planning in postprostatectomy radiotherapy
Institution:2. Institute of Medical Physics, School of Physics, University of Sydney, New South Wales, Australia;3. Northern Clinical School, University of Sydney, New South Wales, Australia;2. Department of Radiation Oncology, Acibadem University, Istanbul, Turkey;3. Institute of Biomedical Engineering, Bogazici University Istanbul, Turkey;4. Istanbul University, Institute of Oncology, Istanbul, Turkey;2. Drexel University College of Medicine, Allegheny Campus, Philadelphia, PA;2. Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, Chicago, IL;2. Optimization and Systems Theory, KTH Royal Institute of Technology, Stockholm, Sweden;3. RaySearch Laboratories, Stockholm, Sweden;4. Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, Northern Ireland, UK;2. Department of Radiology, Baylor College of Medicine, Houston, TX;3. Department of Radiation Oncology, University of Colorado, Denver, CO;4. Department of Radiation Oncology, Duke University, Durham, NC
Abstract:This study is aimed to test a postprostatectomy volumetric-modulated arc therapy (VMAT) planning class solution. The solution applies to both the progressive resolution optimizer algorithm version 2 (PRO 2) and the algorithm version 3 (PRO 3), addressing the effect of an upgraded algorithm. A total of 10 radical postprostatectomy patients received 68 Gy to 95% of the planning target volume (PTV), which was planned using VMAT. Each case followed a set of planning instructions; including contouring, field setup, and predetermined optimization parameters. Each case was run through both algorithms only once, with no user interaction. Results were averaged and compared against Radiation Therapy Oncology Group (RTOG) 0534 end points. In addition, the clinical target volume (CTV) D100, PTV D99, and PTV mean doses were recorded, along with conformity indices (CIs) (95% and 98%) and the homogeneity index. All cases satisfied PTV D95 of 68 Gy and a maximum dose < 74.8 Gy. The average result for the PTV D99 was 64.1 Gy for PRO 2 and 62.1 Gy for PRO 3. The average PTV mean dose for PRO 2 was 71.4 Gy and 71.5 Gy for PRO 3. The CTV D100 average dose was 67.7 and 68.0 Gy for PRO 2 and PRO 3, respectively. The mean homogeneity index for both algorithms was 0.08. The average 95% CI was 1.17 for PRO 2 and 1.19 for PRO 3. For 98%, the average results were 1.08 and 1.12 for PRO 2 and PRO 3, respectively. All cases for each algorithm met the RTOG organs at risk dose constraints. A successful class solution has been established for prostate bed VMAT radiotherapy regardless of the algorithm used.
Keywords:Prostatectomy  VMAT  Class solution
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