skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study

Abstract

Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increasedmore » by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [1]
  1. Department of Radiation Oncology and Molecular Radiation Science, Johns Hopkins University, Baltimore, Maryland (United States)
  2. Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, Maryland (United States)
  3. Autodesk Research, Toronto, ON (Canada)
  4. Department of Radiation Medicine, Georgetown University Hospital, Washington, DC (United States)
  5. Department of Computer Science, Johns Hopkins University, Baltimore, Maryland (United States)
Publication Date:
OSTI Identifier:
22149693
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 5; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AUDITORY ORGANS; BRAIN; COMPARATIVE EVALUATIONS; ESOPHAGUS; HEAD; JAW; LARYNX; MUCOUS MEMBRANES; NECK; NEOPLASMS; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu, Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, McNutt, Todd, Zahurak, Marianna, Simari, Patricio, Pang, Dalong, Taylor, Russell, and Sanguineti, Giuseppe. Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.06.047.
Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu, Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, McNutt, Todd, Zahurak, Marianna, Simari, Patricio, Pang, Dalong, Taylor, Russell, & Sanguineti, Giuseppe. Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study. United States. https://doi.org/10.1016/J.IJROBP.2012.06.047
Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu, Department of Radiation Medicine, Georgetown University Hospital, Washington, DC, McNutt, Todd, Zahurak, Marianna, Simari, Patricio, Pang, Dalong, Taylor, Russell, and Sanguineti, Giuseppe. 2012. "Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study". United States. https://doi.org/10.1016/J.IJROBP.2012.06.047.
@article{osti_22149693,
title = {Fully Automated Simultaneous Integrated Boosted-Intensity Modulated Radiation Therapy Treatment Planning Is Feasible for Head-and-Neck Cancer: A Prospective Clinical Study},
author = {Wu Binbin, E-mail: binbin.wu@gunet.georgetown.edu and Department of Radiation Medicine, Georgetown University Hospital, Washington, DC and McNutt, Todd and Zahurak, Marianna and Simari, Patricio and Pang, Dalong and Taylor, Russell and Sanguineti, Giuseppe},
abstractNote = {Purpose: To prospectively determine whether overlap volume histogram (OVH)-driven, automated simultaneous integrated boosted (SIB)-intensity-modulated radiation therapy (IMRT) treatment planning for head-and-neck cancer can be implemented in clinics. Methods and Materials: A prospective study was designed to compare fully automated plans (APs) created by an OVH-driven, automated planning application with clinical plans (CPs) created by dosimetrists in a 3-dose-level (70 Gy, 63 Gy, and 58.1 Gy), head-and-neck SIB-IMRT planning. Because primary organ sparing (cord, brain, brainstem, mandible, and optic nerve/chiasm) always received the highest priority in clinical planning, the study aimed to show the noninferiority of APs with respect to PTV coverage and secondary organ sparing (parotid, brachial plexus, esophagus, larynx, inner ear, and oral mucosa). The sample size was determined a priori by a superiority hypothesis test that had 85% power to detect a 4% dose decrease in secondary organ sparing with a 2-sided alpha level of 0.05. A generalized estimating equation (GEE) regression model was used for statistical comparison. Results: Forty consecutive patients were accrued from July to December 2010. GEE analysis indicated that in APs, overall average dose to the secondary organs was reduced by 1.16 (95% CI = 0.09-2.33) with P=.04, overall average PTV coverage was increased by 0.26% (95% CI = 0.06-0.47) with P=.02 and overall average dose to the primary organs was reduced by 1.14 Gy (95% CI = 0.45-1.8) with P=.004. A physician determined that all APs could be delivered to patients, and APs were clinically superior in 27 of 40 cases. Conclusions: The application can be implemented in clinics as a fast, reliable, and consistent way of generating plans that need only minor adjustments to meet specific clinical needs.},
doi = {10.1016/J.IJROBP.2012.06.047},
url = {https://www.osti.gov/biblio/22149693}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 84,
place = {United States},
year = {Sat Dec 01 00:00:00 EST 2012},
month = {Sat Dec 01 00:00:00 EST 2012}
}