Evaluation of a software module for adaptive treatment planning and re-irradiation
Abstract Background The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. Methods The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy...
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doaj-7b727075eb804c6bbe28b6c56e0632db2020-11-24T21:11:18ZengBMCRadiation Oncology1748-717X2017-12-011211910.1186/s13014-017-0943-4Evaluation of a software module for adaptive treatment planning and re-irradiationAnne Richter0Stefan Weick1Thomas Krieger2Florian Exner3Sonja Kellner4Bülent Polat5Michael Flentje6Department of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgDepartment of Radiation Oncology, University of WuerzburgAbstract Background The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. Methods The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. Results The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4–35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. Conclusion The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to consider the pretreatment dose, to adapt the actual treatment schema more specifically and to review the accumulated dose.http://link.springer.com/article/10.1186/s13014-017-0943-4Re-irradiationLung cancerAdaptationRe-planning |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne Richter Stefan Weick Thomas Krieger Florian Exner Sonja Kellner Bülent Polat Michael Flentje |
spellingShingle |
Anne Richter Stefan Weick Thomas Krieger Florian Exner Sonja Kellner Bülent Polat Michael Flentje Evaluation of a software module for adaptive treatment planning and re-irradiation Radiation Oncology Re-irradiation Lung cancer Adaptation Re-planning |
author_facet |
Anne Richter Stefan Weick Thomas Krieger Florian Exner Sonja Kellner Bülent Polat Michael Flentje |
author_sort |
Anne Richter |
title |
Evaluation of a software module for adaptive treatment planning and re-irradiation |
title_short |
Evaluation of a software module for adaptive treatment planning and re-irradiation |
title_full |
Evaluation of a software module for adaptive treatment planning and re-irradiation |
title_fullStr |
Evaluation of a software module for adaptive treatment planning and re-irradiation |
title_full_unstemmed |
Evaluation of a software module for adaptive treatment planning and re-irradiation |
title_sort |
evaluation of a software module for adaptive treatment planning and re-irradiation |
publisher |
BMC |
series |
Radiation Oncology |
issn |
1748-717X |
publishDate |
2017-12-01 |
description |
Abstract Background The aim of this work is to validate the Dynamic Planning Module in terms of usability and acceptance in the treatment planning workflow. Methods The Dynamic Planning Module was used for decision making whether a plan adaptation was necessary within one course of radiation therapy. The Module was also used for patients scheduled for re-irradiation to estimate the dose in the pretreated region and calculate the accumulated dose to critical organs at risk. During one year, 370 patients were scheduled for plan adaptation or re-irradiation. All patient cases were classified according to their treated body region. For a sub-group of 20 patients treated with RT for lung cancer, the dosimetric effect of plan adaptation during the main treatment course was evaluated in detail. Changes in tumor volume, frequency of re-planning and the time interval between treatment start and plan adaptation were assessed. Results The Dynamic Planning Tool was used in 20% of treated patients per year for both approaches nearly equally (42% plan adaptation and 58% re-irradiation). Most cases were assessed for the thoracic body region (51%) followed by pelvis (21%) and head and neck cases (10%). The sub-group evaluation showed that unintended plan adaptation was performed in 38% of the scheduled cases. A median time span between first day of treatment and necessity of adaptation of 17 days (range 4–35 days) was observed. PTV changed by 12 ± 12% on average (maximum change 42%). PTV decreased in 18 of 20 cases due to tumor shrinkage and increased in 2 of 20 cases. Re-planning resulted in a reduction of the mean lung dose of the ipsilateral side in 15 of 20 cases. Conclusion The experience of one year showed high acceptance of the Dynamic Planning Module in our department for both physicians and medical physicists. The re-planning can potentially reduce the accumulated dose to the organs at risk and ensure a better target volume coverage. In the re-irradiation situation, the Dynamic Planning Tool was used to consider the pretreatment dose, to adapt the actual treatment schema more specifically and to review the accumulated dose. |
topic |
Re-irradiation Lung cancer Adaptation Re-planning |
url |
http://link.springer.com/article/10.1186/s13014-017-0943-4 |
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