AbstractObjective To compare dosimetric and radiobiological parameters between automatic and manual uARC plans in the treatment of esophageal cancer patients, aiming to provide reference for clinical application. Methods High-quality uARC plans of 100 patients with esophageal cancer were selected, and the mean values of the dosimetric parameters in the target area and organs at risk (OAR) were counted, and the goal table of uRT-TPOIS intelligent plan was established. Automatic and manual uARC plans were generated with UIH (United Imaging) treatment planning system (TPS) for 21 esophageal cancer patients. The differences in mean dose (Dmean), approximate minimum (D98%) and maximum (D2%) dose of planning target volume (PTV), homogeneity index (HI) and conformity index (CI), dose of OAR, mean planning time, monitor unit (MU), tumor control probability (TCP) and normal tissue complication probability (NTCP) were compared between automatic and manual uARC plans. Normally distributed data between two groups were compared by paired t-test, and non-normally distributed data were assessed by nonparametric Wilcoxon test. Results The D98% (PTV60 Gy: P<0.001, PTV54 Gy: P=0.001) , CI (PTV60 Gy: P<0.001, PTV54 Gy: P=0.002) and target volume of area covered by prescription dose (V54 Gy: P<0.001) of the automatic uARC plans were better than those of manual uARC plans (all P<0.05). There was no significant difference in Dmean or HI between the two plans [PTV54 Gy (59.32±1.87) Gy vs. (59.13±1.64) Gy, (0.19±0.02) vs. (0.18±0.02), all P>0.05]. The Dmean and Dmax of spinal cord of the automatic plan were better than those of the manual plan [(13.22±4.27) Gy vs. (13.75±4.44) Gy, P=0.020 and (36.99±1.67) Gy vs. (38.14±1.31) Gy, P=0.011]. There was no significant difference in the mean dose of V20 Gy of the lung between two plans (P>0.05), whereas the mean doses of V5 Gy and V10 Gy of the lung of the manual plan were less than those of the automatic plan ( both P<0. 001). Automatic uARC plan had a significantly shorter mean planning time than manual uARC plan [(11.79±1.71) min vs. (53.36±8.23) min, P<0.001]. MU did not significantly differ between two plans [(762.84±74.83) MU vs. (767.41±80.63) MU, P>0.05]. The TCP of the automatic plan was higher than that of the manual plan (PTV60 Gy 89.15%±0.49% vs. 86.75%±6.46%, P=0.004 and PTV54 Gy 79.79%±3.48% vs. 77.51%±5.04%, P=0.006). However, manual plan had a lower NTCP of the lung than automatic uARC plan (0.46%±0.40% vs. 0.35%±0.32%, P<0.001). There was no significant difference in NTCP of heart and spinal cord between two plans (all P>0.05). Conclusion It is feasible to generate automatic uARC plan with uRT-TPOIS TPS for esophageal cancer patients, which can increase the target CI and shorten the plan design time.
Corresponding Authors:
Han Qian, Email: hq28022009@163.com
Cite this article:
Liang Hengpo,Tao Jinzhu,Han Qian. Feasibility study of automatic uARC planning for esophageal cancer using simultaneous integrated boost radiotherapy[J]. Chinese Journal of Radiation Oncology, 2023, 32(7): 612-619.
Liang Hengpo,Tao Jinzhu,Han Qian. Feasibility study of automatic uARC planning for esophageal cancer using simultaneous integrated boost radiotherapy[J]. Chinese Journal of Radiation Oncology, 2023, 32(7): 612-619.
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2023, Vol. 32 
