Evaluation of volumetric modulated arc therapy planning for rectal cancer based on Auto-Planning
Li Kaixuan,Chang Xi,Wang Jiazhou,Chen Zhi,Wang Junqi,Zhang Zhen,Wan Juefeng,Hu Weigang
Department of Radiation Oncology (Li KX,Chang X,Wang JZ,Wang JQ,Zhang Z,Wan JF,Hu WG),Proton Heavyion Center (Chen Z),Cancer Hospital of Fudan University,Department of Oncology,Shanghai Medical College of Fudan University,Shanghai 200032,China;Department of Radiation Physics,Shanghai Proton Heavy Ion Hospital,Shanghai 210321(Chen Z)
Objective To determine whether Auto-Planning-based volumetric modulated radiotherapy (Auto-VMAT) planning can improve planning efficiency without compromising plan quality compared with current manual trial-and-error-based volumetric modulated arc therapy (Manual-VMAT) planning for patients with rectal cancer. Methods Ten patients with stage Ⅱ-Ⅲ rectal cancer who underwent Dixon surgery were enrolled as subjects. The Pinnacle 9.10 planning system was used to design Manual-VMAT and Auto-VMAT plans. Dose distribution, homogeneity index (HI), conformity index (CI), Dmean values of different organs at risk or dose-volume histogram of regions of interest, total planning time, and manual planning time were compared between the two plans. The differences were analyzed by paired t test. Resutls Dosimetric prescriptions were achieved in both plans. There were no significant differences in HI or CI between the Auto-VMAT plans and the Manual-VMAT plans (0.058 vs. 0.058, P=0.972;0.921 vs. 0.940, P=0.115). Compared with the Manual-VMAT plans, the V40, Dmean, and D50% of the bladder were significantly reduced by 25.6%, 11.5%, and 8.9%, respectively, in the Auto-VMAT plans (P=0.004, 0.016, 0.001);the V40, Dmean, and D50% of the small intestine were also significantly reduced by 12.1%, 5.4%, and 6.8%, respectively, in the Auto-VMAT plans (P=0.023, 0.001, 0.001);the V30, Dmean, and D50% of the left and right femoral heads were slightly reduced in the Auto-VMAT plans. The Auto-VMAT plans had significantly longer total planning time but significantly shorter manual planning time than the Manual-VMAT plans (50.38 vs. 36.81 min, P=0.000;4.47 vs. 16.94 min, P=0.000). Conclutions Compared with the Manual-VMAT plans, the Auto-VMAT plans have substantially shorter manual planning time and improved planning efficiency.
Li Kaixuan,Chang Xi,Wang Jiazhou et al. Evaluation of volumetric modulated arc therapy planning for rectal cancer based on Auto-Planning[J]. Chinese Journal of Radiation Oncology, 2017, 26(11): 1308-1312.
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